The end of the year is one of the busiest times for therapy practices. Between staff schedules, holiday closures, and wrapping up client care, billing can easily slip through the cracks. But overlooking just a few key details in November and December can snowball into major headaches (and lost revenue) come January.

Here are five common year-end billing mistakes to watch out for and how to avoid them.

1. Leaving Aging Claims Unresolved

   It's easy to push denials or unpaid claims further down the to-do list, especially during busy months. But the longer they sit, the harder they are to recover and the more they impact your January revenue. A backlog of aging claims can also mask patterns, like repeated coding errors or missing documentation.

Avoid It: Review your accounts receivable aging report before year-end. Highlight anything over 60 or 90 days and create a plan to address them. Even if not every claim can be resolved before December 31st, documenting next steps ensures nothing gets lost in the shuffle.

2. Forgetting to Renew Expiring Authorizations

   Many insurance payors align authorizations with the calendar year. That means a large chunk of your clients may have authorizations ending in December. If your team doesn't catch this, January sessions can get denied leaving you with frustrated families and revenue tied up until renewals are processed.

   
   

   Avoid It: Start early. Run a report of all clients with authorizations expiring this quarter and submit renewals well before the holidays. Keep a clear tracking system so nothing slips through the cracks, and assign one person to monitor authorization requests until approval is received.

3. Skipping Billing During Holiday Closures

   With staff on vacation and offices closed, billing may get delayed and sometimes for weeks. What feels like a small pause in December can snowball into a January nightmare, with double the work and delayed collections that hurt your cash flow.

   
   

   Avoid It: Build billing coverage into your holiday schedule. Whether it's assigning a single team member to log in twice a week or outsourcing billing tasks temporarily, consistency is key. Claims should continue going out on schedule, even if your office is quieter than usual.

4. Overlooking Client Schedule Changes

   The holidays bring cancellations, no-shows and shifting availability. If sessions are billed without reflecting these changes, claims can be inaccurate and rejected creating extra work in January to void or correct them. Worse, repeated errors may raise red flags with payors.

   
   

   Avoid It: Stay proactive. Have your scheduling team communicate closely with your billing team, and update your system daily with any changes in attendance. Encourage staff to confirm appointments ahead of holiday weeks, so fewer surprises trickle down into billing.

   
   

5. Not Reconciling Your Year-End Reports

   Many practices don't take time to review their year-end billing and financial data until it's too late. Without reconciling reports, you could be carrying errors into the new year, underestimating your collections or missing denial trends that need to be fixed.

   
   

   Avoid It: Run your year-end reports including collections, denials, and utilization comparing them against your practice management system. Reconciling ensures your records are accurate for tax season and gives you a clear picture of your practice's financial health heading into 2026.

Year-end doesn't have to mean chaos. By tackling these common billing pitfalls now, you'll keep cash flow steady, avoid unnecessary denials, and set your practice up for a smoother start to 2026.

Need an extra hand to get billing off your plate? Ārohana Support specializes in helping therapy practices stay compliant and profitable without the January stress.