As 2026 comes to a close, there’s one question every medical practice should be asking:
How much of your hard-earned revenue is still sitting in unpaid claims?
Between delayed insurance payments, unresolved denials, underpayments, and outstanding patient balances, it’s easy for revenue to slip through the cracks. And when your billing team is busy keeping up with daily claims, older accounts can quickly get pushed to the back burner.
The problem? Unpaid claims don’t always get easier to collect with time.
The good news is that some of that revenue may still be recoverable. A focused year-end medical billing review can help your practice identify outstanding payments, address billing issues, and enter 2027 with a healthier revenue cycle.
At BillVolt, we know that successful medical billing goes beyond submitting claims. It requires a consistent, detail-oriented approach to tracking payments, resolving denials, and following up until every eligible dollar has been accounted for.
Here’s how your practice can make the most of its year-end revenue recovery efforts.
1. Start Your Year-End Medical Billing Review With an A/R Aging Report
Your accounts receivable aging report is one of the most valuable tools for identifying unpaid medical claims.
It shows how long outstanding balances have been sitting in your A/R and helps your billing team determine which accounts need immediate attention.
A typical A/R aging report includes the following categories:
| A/R Aging | What to Review |
| 0–30 days | Recently submitted claims and normal payer processing timelines |
| 31–60 days | Claims requiring payment status verification or follow-up |
| 61–90 days | Delayed claims that may need additional investigation |
| 91–120 days | Aging balances requiring more aggressive follow-up |
| 120+ days | High-risk accounts that may have limited recovery opportunities |
While older claims deserve attention, the smartest approach isn’t always to work the oldest accounts first.
For example, a $5,000 claim that’s 45 days old and approaching its appeal deadline may be more urgent than a $200 claim that’s 150 days old but still within a routine payer processing cycle.
A strong A/R management strategy considers:
- Outstanding balance and potential reimbursement.
- Claim age and payer processing status.
- Timely filing and appeal deadlines.
- Previous follow-up attempts.
- The reason payment has been delayed.
BillVolt insight: Effective A/R management is about prioritizing the right accounts, not simply working through a report from oldest to newest.
2. Identify Unpaid Claims Before Timely Filing Deadlines Expire
One of the most costly medical billing mistakes is allowing a claim to miss its timely filing deadline.
Once a claim falls outside the payer’s filing window, reimbursement may be denied, even when the services were medically necessary and properly documented.
For Medicare, claims generally must be submitted within 12 months, or one full calendar year, from the date of service, unless an exception applies. Commercial insurance companies and other payers may have different filing requirements. Medicare’s official claims guidance explains the applicable general timeframe.
Before year-end, your billing team should:
- Identify encounters with charges that have not yet been submitted.
- Review clearinghouse rejections and claims requiring correction.
- Verify that submitted claims were received by the payer.
- Check payer-specific timely filing requirements.
- Prioritize claims approaching their filing deadlines.
- Review secondary claims and outstanding coordination of benefits issues.
It’s important to understand that December 31 is not a universal claims filing deadline.
A claim’s filing deadline depends on the payer, date of service, and applicable billing requirements. Your team should review each claim individually rather than assume that all outstanding claims must be submitted before the calendar year ends.
The goal is simple: Don’t let an otherwise payable claim become uncollectible because of a preventable filing delay.
3. Revisit Denied Claims That May Still Be Recoverable
A denied claim doesn’t necessarily mean the revenue is lost.
An effective year-end medical billing strategy includes reviewing denied claims that may still qualify for correction, reconsideration, or appeal.
In many cases, claims can be corrected, reconsidered, or appealed, depending on the denial reason and the payer’s requirements.
The challenge is determining which denials are recoverable and what needs to happen before resubmission or appeal.
Common medical billing denial reasons include:
- Incorrect patient demographics or insurance information.
- Missing or invalid prior authorization.
- CPT, ICD-10-CM, or modifier-related issues.
- Eligibility and coverage discrepancies.
- Provider credentialing or enrollment problems.
- Missing or insufficient medical documentation.
- Duplicate claims or incorrect claim submissions.
For example, a claim may be denied because the rendering provider’s information doesn’t match the payer’s enrollment records.
Simply resubmitting the claim without correcting the underlying issue is unlikely to resolve the denial. The billing team must investigate the enrollment discrepancy, determine the appropriate correction, and follow the payer’s process.
This is where experienced denial management makes a difference.
A thorough denial review should identify:
- The original denial reason.
- Whether the claim is eligible for correction or appeal.
- The documentation or information needed.
- The applicable submission deadline.
- The next action and responsible team member.
It’s also important to look beyond individual claims.
If multiple claims are being denied for the same reason, the issue may involve a recurring workflow problem, payer configuration, credentialing discrepancy, or front-end billing error.
The real opportunity is twofold: Recover eligible denied revenue and prevent the same issue from affecting future claims.
4. Investigate Insurance Underpayments and Payment Discrepancies
Getting paid is important. Getting paid correctly is just as important.
An insurance claim can show as paid in your billing system while the actual reimbursement is lower than the amount your practice should have received under the applicable contract or payment terms.
These differences can be difficult to identify without a structured payment reconciliation process.
Your team should compare:
- Contracted reimbursement rates and payer fee schedules.
- Expected reimbursement amounts.
- Electronic remittance advice (ERA).
- Electronic funds transfer (EFT) records.
- Actual bank deposits.
- Contractual adjustments and patient responsibility.
Example: Identifying an insurance underpayment
Let’s say your practice expects $250 for a service based on its applicable contracted reimbursement rate.
The payer processes the claim and pays $180.
| Description | Amount |
| Expected reimbursement | $250 |
| Actual insurance payment | $180 |
| Potential payment discrepancy | $70 |
That $70 difference deserves investigation.
However, not every payment discrepancy is an underpayment. Before initiating a dispute, your team should verify the applicable contract, fee schedule, claim adjustments, bundling rules, modifiers, and patient responsibility.
A payment reconciliation review should also identify:
- Unapplied insurance payments.
- Incorrect contractual adjustments.
- Duplicate payment postings.
- Payments posted to the wrong patient or account.
- Differences between ERA amounts and bank deposits.
An accurate payment reconciliation process helps your practice understand not just what was paid, but whether the payment was correct.
5. Review Outstanding Patient Balances
Insurance A/R isn’t the only source of outstanding revenue.
Patient balances can also accumulate throughout the year, particularly when deductibles, copayments, and coinsurance amounts are not collected or followed up on consistently.
Before sending patient balances to collections or carrying them into the new year, make sure the amounts are accurate.
A patient balance review should include:
- Verifying that insurance has completed processing.
- Confirming the patient’s actual financial responsibility.
- Reviewing contractual adjustments and payment postings.
- Identifying inaccurate or duplicate balances.
- Sending clear, itemized patient statements.
- Offering convenient and secure payment options.
- Establishing payment arrangements when appropriate.
One important consideration: A denied insurance claim should not automatically become a patient balance.
Your team must determine whether the denial is the patient’s responsibility under the applicable payer contract, benefit plan, and billing requirements.
For example, a claim denied due to a provider enrollment issue may require additional investigation before any patient billing is appropriate.
Accurate statements and clear communication can improve patient collections without creating unnecessary confusion or damaging patient relationships.
6. Audit Your Medical Billing and Coding Workflows
Recovering unpaid revenue is important, but preventing future revenue loss is where long-term improvement begins.
A year-end medical billing audit gives your practice an opportunity to identify the operational issues that may be slowing down reimbursement.
Look for recurring problems such as:
- Delayed charge entry and unbilled encounters.
- Incorrect CPT or ICD-10-CM code selection.
- Missing or inappropriate modifiers.
- Eligibility verification errors.
- Prior authorization workflow gaps.
- Provider credentialing discrepancies.
- Unresolved clearinghouse rejections.
- Delayed insurance payment posting.
- Inconsistent denial follow-up.
For example, if your practice regularly experiences delays between the date of service and claim submission, the problem may not be with the insurance company at all.
It could be a charge capture issue, incomplete documentation, or a workflow that allows encounters to remain unbilled for too long.
The same applies to denials. A high denial rate may indicate a recurring problem that needs to be addressed at the front end of the revenue cycle.
Prepare your practice for 2027 coding updates
Year-end is also a good time to review applicable coding and payer policy updates.
The FY 2027 ICD-10-CM code set became effective October 1, 2026, for applicable healthcare services. Practices should make sure their coding workflows, billing systems, and staff are using the appropriate code set for the date of service. The CDC’s ICD-10-CM resources provide the official code releases and effective dates.
Coding accuracy is not just about avoiding denials. It also supports compliant claims submission, appropriate reimbursement, and a more reliable revenue cycle.
7. Build a 30-Day Year-End Revenue Recovery Plan
A structured recovery plan helps your team focus on the claims that matter most instead of trying to address every outstanding balance at once.
Here’s a practical 30-day approach your practice can use before entering 2027.
| Timeline | Priority |
| Week 1 | Review A/R aging, identify unbilled charges, and prioritize unpaid claims. |
| Week 2 | Resolve high-priority denials, correct eligible claims, and submit appeals before applicable deadlines. |
| Week 3 | Investigate underpayments, reconcile payments, and review outstanding patient balances. |
| Week 4 | Evaluate recovery results, address remaining high-risk accounts, and prepare billing workflows for 2027. |
Throughout the process, track key medical billing performance indicators, including:
- Total outstanding A/R.
- A/R over 90 days.
- A/R over 120 days.
- Denial rate and denial reasons.
- Unbilled charges.
- Amount of revenue recovered.
- Payment posting accuracy.
- Net collection performance.
These metrics help your practice measure progress and identify areas that need continued attention.
Keep in mind that a 30-day plan is a framework for organizing recovery efforts. Actual payment timelines depend on payer processing, documentation requirements, appeal procedures, and other factors outside your practice’s control.
The objective is to make measurable progress while ensuring that every claim receives the appropriate follow-up.
Start 2027 With a Stronger Revenue Cycle
Year-end medical billing isn’t just about closing the books. It’s about making sure your practice has done everything reasonably possible to collect the revenue it has earned.
Unpaid medical claims don’t automatically become uncollectible at the end of the year. But missed filing deadlines, unresolved denials, inaccurate payment postings, and inconsistent follow-up can significantly reduce your chances of recovery.
A proactive year-end medical billing review can help your practice:
- Recover eligible outstanding revenue.
- Reduce aging accounts receivable.
- Identify and address preventable denials.
- Improve payment reconciliation.
- Strengthen billing workflows.
- Enter 2027 with better visibility into financial performance.
And when your billing team has a clear strategy for addressing outstanding claims, it can spend less time reacting to billing problems and more time keeping the revenue cycle moving.
Let BillVolt Help You Recover Outstanding Revenue
At BillVolt, we understand that medical billing is more than claim submission. It’s about managing the entire revenue cycle, from charge entry and claims processing to denial management, insurance follow-up, and A/R recovery.
We work with healthcare providers across the United States to help streamline medical billing operations, resolve outstanding claims, and improve revenue cycle performance.
Whether your practice is dealing with aging A/R, recurring denials, payment discrepancies, or a backlog of unpaid claims, our team can help you identify opportunities to improve collections and strengthen your billing process.
Don’t let recoverable revenue sit unpaid.
Contact BillVolt to schedule a free consultation and discuss how we can help your practice improve its revenue cycle before 2027.
Frequently Asked Questions About Year-End Medical Billing
How can medical practices recover unpaid claims before year-end?
Medical practices can recover eligible unpaid claims by reviewing A/R aging reports, identifying unsubmitted charges, correcting rejected claims, appealing eligible denials, investigating underpayments, and following up with insurance companies before applicable deadlines.
Can denied medical claims be recovered after December 31?
Yes. A denied claim may still be recoverable after December 31 if the payer’s applicable correction, reconsideration, or appeal deadline has not expired. Recovery depends on the denial reason, payer requirements, and supporting documentation.
What is the most important year-end medical billing report?
The A/R aging report is an essential starting point for year-end revenue recovery. However, it should be reviewed alongside denial reports, unbilled charge reports, payment reconciliation records, and payer-specific claim status information.
What is a good A/R aging target for a medical practice?
A/R benchmarks vary by specialty, payer mix, practice size, and billing model. Practices should monitor the percentage of A/R over 90 days, over 120 days, and overall days in A/R. The goal is to reduce avoidable aging while maintaining accurate reporting and consistent follow-up.
How can outsourced medical billing improve collections?
An experienced medical billing partner can support claim submission, insurance follow-up, denial management, payment reconciliation, and accounts receivable recovery. Consistent follow-up and a structured billing workflow can help practices identify payment opportunities and reduce preventable revenue loss.
What should a medical practice review before starting a new year?
Before the new year, practices should review outstanding A/R, unresolved denials, unbilled encounters, payer filing deadlines, payment discrepancies, patient balances, provider enrollment issues, and applicable coding updates. This helps establish a clearer financial picture and a more organized revenue cycle for the coming year.
