A year-end AR cleanup means working your aging buckets, checking timely filing limits and clearing patient balances before January 1. Once deductibles reset, older balances get harder to collect, so the last weeks of the year are the best time to tighten up your medical billing accounts receivable.
Why does January 1 change the math on collections?
Medicare Part B deductibles run on the calendar year and reset every January 1. For 2026 the Part B deductible is $283, per CMS. Many commercial plans also use a calendar-year deductible, though some employer plans reset on a different date, so check the plan year for your largest payers. A patient who has met their deductible usually owes little on a clean claim. Bill the same service in January and a good share of it can fall back on the patient until the new deductible is met.
That timing affects your AR in two ways. Payer-side claims you resolve before year-end are more likely to pay while deductibles are still met. Patient balances that slide into January end up competing with new out-of-pocket costs from current visits, so they get paid more slowly. So push now on the payer claims you can still fix, and get statements in front of patients well before the reset. Before you schedule high-dollar visits in December, check how much of each patient’s deductible is left, since that tells you how much will actually be paid this year.
Which aging buckets do you work first?
AR aging sorts balances by age: 0 to 30 days, 31 to 60, 61 to 90, 91 to 120, and over 120. Older balances are harder to collect, and anything past 120 days needs a review before it becomes a write-off. For a year-end push, work them in this order:
- 91 to 120 days. These are closest to timely filing limits and write-off. Start here.
- Over 120 days. Decide on an appeal, a corrected claim or a documented write-off so your AR reflects what you can actually collect.
- 61 to 90 days. Clear denials and information requests before they age further.
- 0 to 60 days. Keep them moving so they do not become next quarter’s problem.
Working the aged buckets is the core of accounts receivable management. Give each aged claim an owner and a next step with a date, because claims without an owner keep aging. If your team does not have the hours to work the older buckets before year-end, that is work you can hand off.
What should your AR report show before you start?
Before anyone starts calling payers, get an aging report you can trust. Run it by payer and by date of service, not only by total dollars, so you can see which payers are holding the most money and for how long.
A few things are worth pulling out on their own. Separate credit balances, since netting them against open balances makes total AR look smaller than it is. Flag claims with no activity in the last 30 days, because those are usually waiting on something nobody is tracking. And keep true denials apart from claims that were rejected and never accepted by the payer, since the two get worked differently.
If your billing company cannot produce a report like this, our post on AR that keeps climbing with no answers from your vendor covers what to ask for. GI practices may also want to read why gastroenterology AR keeps growing.
How do timely filing limits create a hard deadline?
Every payer sets a deadline for filing a claim after the date of service. Miss it and the claim is denied, usually with no way to recover it, and a service you already provided becomes a write-off.
Medicare has a firm limit. Under Section 6404 of the Affordable Care Act, Medicare fee-for-service claims must be filed within 12 months of the date of service. Commercial payers set their own limits, and many are much shorter than a year. Some are as short as 90 days, so check the contracts for your largest payers.
Pull any date of service from late last year that is close to its filing deadline and confirm there is a clean, accepted claim on file. A claim rejected as unprocessable does not count as filed, so a rejection that no one worked can miss the deadline while it sits in a queue. Denials that still have appeal rights need to move now, while there is time to correct and resubmit. Our denial management team can work those appeals against each payer’s deadline so the money does not expire.
Watch secondary claims as well. A secondary claim usually cannot go out until the primary payer has paid or denied, so a primary denial nobody worked can hold up two payments instead of one. Check each secondary payer’s filing rules, since some count from the primary payer’s decision and some from the date of service.
What is the right way to clear patient balances before the reset?
Patients now pay a bigger share of the bill than they used to, and patient balances behave differently from payer balances. They get paid faster when the statement is clear and paying takes a minute.
Before January 1, send current statements on every open patient balance so nothing goes quiet into the new year. Offer an easy way to pay, including payment plans on larger balances. Flag any account where a secondary payer was missed, since a coordination of benefits fix can move the balance off the patient entirely. Then reconcile credit balances and refunds so your year-end numbers are accurate.
For larger balances, a short phone call often works better than a third statement. Keep it simple: the amount, what it was for and the ways to pay. Patients who understand the bill are more likely to pay it.
If these are cleared now, your team starts January on current visits instead of chasing last year’s balances while new deductibles build up. It also helps to run eligibility on January appointments ahead of time so the front desk can collect toward the new deductible at check-in. If you would rather have aging work every month than in a December rush, that is part of our revenue cycle management service.
Frequently asked questions
When should we start a year-end AR cleanup?
Start in the fourth quarter so you have time to fix and resubmit claims before timely filing limits and the January 1 deductible reset. Starting early also gives your team time to work the oldest buckets instead of writing them off.
What is Medicare’s timely filing limit?
Medicare fee-for-service claims must be filed within 12 months of the date of service under Section 6404 of the Affordable Care Act. Commercial limits vary and are often shorter.
Which bucket should we prioritize at year-end?
Start with 91 to 120 days, since those balances sit closest to timely filing limits and write-off, then triage anything over 120.
Why are patient balances harder to collect in January?
When calendar-year deductibles reset January 1, patients owe more on new visits, so older balances compete with current costs and get paid more slowly.
Want a clear read on your aged AR before year-end? Get Pricing & Analysis.
