End-of-Year Best Dental Management & Billing Practices
Where Your Energy Should Be Focused + KPIs to Review + How to Systemize Your Billing in 2026
December isn’t just the end of the year — it’s the most important month for your revenue cycle, practice performance, and future cash flow.
This is the month where your systems either protect your practice, or problems roll over into 2026 and compound.
At Elite Dental Systems, we want to support you with the exact systems, reporting, and end-of-year strategies that keep your practice thriving — not scrambling.
Let’s dive in.
Where Your Energy Should Be Focused in December
December is your “RCM pressure test.” When systems are weak, they show. When systems are strong, this month becomes your biggest financial win.
Here are the 5 areas that require your full focus:
1. Aging A/R (Nothing Should Be Older Than 90 Days)
Resolve unpaid EOBs
Resubmit claims missing attachments (just the attachments)
Correct inaccurate denials & underpayments (ex: general dentist fees vs specialty if wrong rendering provider was billed)
Call insurance before the holidays (delays are longer in December)
2. Benefit Maximums & Deductible Resets
Patients often don’t know their benefits renew in January. Your team should:
Run unscheduled treatment reports
Create year-end outreach lists
Offer prepayment or deposits for January appointments
3. Cleaning Up Outstanding Claims
Every unresolved claim today becomes a January denial or write-off tomorrow.
Make sure:
No claims remain “pending documentation.”
All perio/SRP claims have perio charting + X-rays, type of anesthetic used, and length of time it took to complete the treatment - (make sure your PMS is set up to prompt your clinical team to notate these specific things for insurance claim payment)
All crown claims have PA + narrative (pre op& post op)
All SRP, OS, and emergency codes have proper documentation & coding
4. Reviewing Treatment Plans That Need Action Before Dec 31
Especially:
Crowns
SRP
Extractions
Implants
Recalls due now
Cases that need new benefits in January
5. Preparing For CDT 2026 Updates
Your software, multi-codes, fee schedules, documentation templates, and routing slips must all be updated.
This is the best time to clean, update, and reset.
End-of-Year KPIs Every Dental Practice Must Review
The numbers you review in December determine how you plan for 2026.
The most important KPIs (Key Performance Indicators) related to the dental billing department and revenue cycle management focus on measuring the efficiency of billing, collections, and the overall financial health of the dental practice. Some of these KPIs include:
1. Production vs. Collections (%)
Are you collecting 98–100% of adjusted production?
Any consistent shortfalls?
If under 90% → Your systems, not your patients, are the issue.
At the simplest level you want:
Collection-to-production ratio = Total collections ÷ Total gross production × 100
If you use net production (after adjustments/write‑offs):
Collection-to-net-production ratio = Total collections ÷ Net production (gross production − adjustments/write‑offs) × 100
2. A/R Over 90 Days
Target: Less than 10% of total A/R
If it’s higher, this signals:
inconsistent follow-up
unresolved denied claims
batching issues
missing attachments
Incomplete documentation from providers
Equation:
A/R Over 90 Days % = Total A/R in 90 day bucket ÷ Total A/R × 100
With your target, you would monitor: A/R Over 90 Days %<10%
Example for A/R Over 90 Days
Assume your aging report shows:
Total A/R (all buckets) = $120,000
A/R in 90+ days bucket = $9,000
Equation:
A/R Over 90 Days % = 9,000 ÷ 120,000 ×100 = 7.5%
Since 7.5% is under the 10% target, this would be considered healthy for that KPI.
3. Claim Turnaround Time
Goal: Claims paid within 7–14 days
If your claims exceed 21–30 days, the issue is usually:
bad documentation
incorrect coding
missing attachments
lack of daily follow-up
improper narratives
Clean Claim Rate = Number of Claims Paid on First Submission ÷ Total Number of Claims Submitted × 100
4. Denial Rate
The percentage of insurance claims rejected. A low denial rate, under 5%, means effective claim management and fewer revenue losses due to rejections.
Denial rate = Number of denied claims ÷ Total number of claims submitted x 100
5. Insurance Aging by Carrier
Highest aging carriers tell you exactly where your system is failing:
Delta? → documentation issues
Aetna? → missing narratives
Cigna? → code bundling or plan exclusions
This tells you what to fix first in 2026.
6. Outstanding Patient Ledger Balances
Look for:
repeated under-collection
missing pre-estimates
uncollected co-pays
poor financial communication
These are fixable with scripts + systems.
How to Use What You Learn in December to Strengthen 2026
December data tells you exactly what your practice needs next year.
Here’s how to use your EOY review to build a stronger 2026:
✔ If A/R was high →
You need an A/R Workflow, weekly follow-up schedule, and denial management system.
✔ If documentation caused denials →
You need updated provider templates, CDT 2026-compliant notes, and a documentation training.
✔ If insurance aging is inconsistent →
You need carrier-specific workflows and improved attachments.
✔ If patient balances increased→
You need financial policy scripts, better pre-estimates, and payment collection protocols.
✔ If claims took too long to pay→
You need a Clean Claim System (Elite Dental Systems specializes in this).
✔ If you found lost revenue you never noticed →
You need a monthly RCM reporting system.
How to Improve & Systemize Your Billing for 2026
2026 is the year to stop “putting out fires” and start building systems that work for you.
Below are the core systems every dental practice needs in 2026.
⭐ 1. Insurance Verification System (VOB Workflow)
Every office needs:
VOB Breakdown specific to the practice
Written verification workflow (SOPs)
Predetermination policy (Medicaid/HMO offices)
Red flag identification - making sure the information the patient provides matches what insurance has on file from day 1
Elite Dental Systems can create your entire VOB workflow.
⭐ 2. Documentation System (Provider Templates)
Every procedure must have:
clinical indications
diagnosis
tooth numbers
steps completed
materials used
post-op notes
justification for necessity
Your templates must match CDT 2026 changes.
⭐ 3. Clean Claim Submission Workflow
A system that ensures:
correct codes
correct attachments
correct narratives
correct documentation
correct DOS
correct place-of-service
⭐ 4. Denial Management System
Where practices lose the most money.
Your denial system should include:
daily denial review
same-day corrective resubmissions
carrier-specific appeal templates
documentation checklists
weekly A/R meetings/reporting
⭐ 5. Financial Communication System
Train your team on:
explaining patient portions
presenting treatment plans
reviewing downgrades
discussing exclusions
payment plan options
scheduling for financial success
📥 NEW THIS MONTH: Download Your End-of-Year Billing Checklist (PDF)
Our 2025 End-of-Year Dental Billing & Compliance Checklist is now available on The Dental Detective blog.
It includes everything you need to:
✔ Reset insurance maximums
✔ Verify new benefit year changes
✔ Update CDT 2026 codes
✔ Clean up AR & appeals
✔ Prepare systems for January 1st
👉 Download the EOY Checklist: Download Here
This is the perfect tool for office managers, billers, and providers who want to start 2026 with a clean slate. December is your month to pause, reset, and refine. Our team is here to help you navigate EOY tasks, CDT updates, and all things RCM so you can step into 2026 with complete confidence.
From claim submissions to medical-dental cross-coding to full RCM startup — we’ve got you.
Let Elite Dental Systems Help You Start 2026 Strong.
Here’s how we can support your practice:
✔ CDT 2026 Coding Update & Implementation
✔ A/R Cleanup & Denial Management
✔ Clean Claim Workflow Setup
✔ Insurance Verification Scripts & System
✔ UCR Fee Schedule Assessment for 2026
✔ Full RCM Audit & Systems Implementation
Book your 2026 Strategy Session: 👉 https://elitedentalsystems.com/contact
Your practice deserves billing systems that are stable, ethical, efficient, and profitable. Elite Dental Systems is here to help you build them.
Here’s to ending 2025 strong — and entering 2026 with clarity, confidence, and systems that work.
