Year-End Revenue Cycle Management Activities for Dental Practices

Review Outstanding Claims and Accounts Receivables (A/R)

Unresolved claims and unpaid balances can significantly impact your practice’s cash flow. Ensure you're reviewing your claims and A/R regularly to avoid unnecessary losses.

Identify Unresolved Claims: Run reports to identify all outstanding claims, focusing on high-value and older claims that are nearing timely filing limits.

Follow Up on A/R Aging Reports: Categorize unpaid patient balances by aging buckets (30, 60, 90 days) and develop a strategy to collect them before they become delinquent.

Negotiate with Insurance Carriers: If claims are denied or underpaid, appeal promptly to recover maximum reimbursements.

Analyze and Update Fee Schedules

Year-end is a great time to evaluate your fee schedules and ensure your practice is in line with market standards and insurance reimbursement rates.

Compare Fee Schedules with Payer Reimbursements: Ensure that your fees align with current insurance reimbursements and market rates, preventing underbilling.

Negotiate New Fee Schedules for the Coming Year: Some payers allow updates or negotiations at year-end. Take advantage of this to maximize revenue potential.

Conduct a Coding and Documentation Audit

Accurate coding and documentation are critical to avoid claim rejections or denials and ensure compliance with regulatory standards.

Check for Changes in CDT Codes: The American Dental Association (ADA) releases annual updates to CDT codes. Ensure that your coding is up-to-date to avoid claim rejections.

Audit Clinical Documentation: Review clinical notes and documentation to confirm they support the procedures billed, reducing the risk of denials during audits.

Plan Year-End Patient Outreach Campaigns

Patient outreach is crucial during the last quarter to help patients maximize their insurance benefits and settle outstanding balances.

Maximize Year-End Insurance Benefits: Remind patients to schedule appointments to use their remaining insurance benefits before they expire.

Collect Patient Balances: Send friendly reminders to patients with outstanding balances and offer flexible payment plans to encourage timely payments.

Reconcile Payments and Financial Reports

Year-end reconciliation is essential to ensure that all revenue is accurately accounted for and that there are no discrepancies.

Verify Payer Payments: Match posted payments against Explanation of Benefits (EOBs) to ensure there are no underpayments.

Reconcile Bank Statements with RCM Records: Make sure that all revenue generated by the practice is correctly deposited into the bank account and matches your RCM records.

Prepare for Tax Reporting and Compliance

Year-end tax preparations and compliance checks ensure that your practice is ready for tax season and regulatory audits.

Review Tax Documents: Verify that all revenue-related documentation is in order for year-end tax filings to prevent delays or penalties.

Ensure HIPAA and Compliance Reviews: Conduct an internal audit of patient data to ensure compliance with HIPAA and other relevant regulations.

Evaluate Practice Management Software Performance

Your practice management software plays a crucial role in efficient dental RCM processes. Assess its performance and plan for any necessary upgrades.

Assess Software Efficiency: Review whether your current practice management system supports all your **dental RCM processes ** Bold efficiently. Tools like CareStack can offer all-in-one solutions for managing RCM.

Plan for Software Upgrades: If your software is outdated or lacks functionality, consider upgrading or enhancing your system to streamline workflows in the coming year.

Review Performance Metrics and Set New Goals

Reviewing RCM performance metrics helps you identify areas for improvement and set achievable financial goals for the upcoming year.

Analyze Key RCM Metrics: Review important KPIs such as collection rates, days in A/R, and denial rates. Identify any bottlenecks or issues that need addressing.

Set Financial Goals for the New Year: Use the data you’ve gathered throughout the year to set realistic revenue and collection targets for the new year.

Is your dental practice facing challenges with revenue cycle management, especially as the year comes to a close? CareRevenue, an integrated solution within CareStack, is here to help streamline your financial operations and ensure a seamless transition into the new year. By leveraging CareStack's all-in-one cloud-based practice management platform, CareRevenue offers specialized RCM services tailored for dental practices. This includes optimizing billing, managing claims, reducing denials, and boosting cash flow—all while allowing your team to focus on patient care. From fee schedule analysis to coding audits and payment reconciliation, CareRevenue provides the expertise and tools to detect revenue leaks, enhance workflow efficiency, and maximize your practice's profitability. Ready to elevate your practice’s financial health? Reach out today to discover how CareRevenue can transform your operations and set you up for a successful year ahead!