Year-End Readiness for ABA & Pediatric Therapy Practices: A Quick Guide

As fall rolls in, now is one of the smartest times in the year for ABA and pediatric therapy practices to get organized. The work you do now to tidy up operations, planning, and finances can significantly pay off in avoiding end-of-year scramble, reducing stress, and starting 2026 strong. Below is a checklist and guidance to help you use the next few months effectively.

Why Year-End Readiness Matters

• Helps prevent revenue loss due to missed claims, insurance renewals, or operational backlogs.

• Ensures compliance with changing payer, insurance, or licensing requirements.

• Sets you up to hit the ground running in the new year, instead of playing catch-up.

• Gives you time to budget, set goals, and plan staffing / scheduling before the yearly rush.

Key Areas to Focus On: Your Year-End Checklist

Area	What to Do Now	Why It Matters
Financial & Billing Clean-Up	• Submit outstanding claims & follow up on unpaid / denied ones. • Review denial rates & documentation to identify patterns. • Reconcile accounts receivable; ensure your books accurately reflect what’s owed.	Unbilled or delayed claims = lost revenue. Clean finances mean better forecasting.
Insurance / Payer Contracts & Renewals	• Mark renewal dates for contracts (insurance carriers, malpractice, liability, etc.). • Review existing policies: coverage levels, premiums, what’s changed in your practice (staff, services) that might affect rates. • If you plan to change carriers or negotiate, begin talks early (often 90‐120 days ahead). • Communicate with your staff about any upcoming open enrollment or benefit changes.	Rates may increase; missing deadlines can lead to gaps. Early review gives bargaining power.
Scheduling & Capacity Planning	• Examine client appointment patterns; anticipate changes for holidays or school schedules. • Review staff availability / PTO, potential hiring needs for 2026. • Block out holiday closures and plan how to handle coverage or emergencies.	Smooth client experience, less burnout, fewer surprises.
Budget & Goal Setting for Next Year	• Project revenues and expenses for 2026. • Identify investments: software upgrades, staff training, changes in lease / overhead. • Set operational / productivity / quality goals. • Consider key metrics: utilization, no-show rates, payer mix, etc.	Helps with resource allocation; gives you performance markers to measure vs. throughout the year.
Operations & Compliance Check	• Update credentialing, licensure, and any required certifications. • Review vendor agreements / contracts (including Business Associate Agreements for HIPAA or privacy). • Audit your documentation practices, data integrity (client files, authorizations). • Check for upcoming regulatory changes (state, payer, Medicaid/Medicare) that may take effect in the new calendar year. • Ensure your billing and EHR / practice management software is configured correctly for any new payer or code changes.	Non-compliance can lead to denials or penalties; being proactive avoids scrambling later.

Sample Timeline: What To Do & When

• Now (September - October): 

  • Start auditing claims & financials.

  • Identify upcoming insurance renewals, contract end dates.

  • Engage staff about any major scheduling changes.

• Mid-Fall (October - November):

  • Finalize budget & goals for 2026.

  • Reach out to insurance carriers / brokers for renewal quotes.

  • Update any license / credential renewals.

  • Clean up or archive old client records or files where appropriate.

• Late Fall / Early Winter (November - December):

  • Confirm any plan changes go live in January.

  • Communicate with clients and staff about holiday schedules.

  • Run a 2026 benefits check and calculate your client's 2026 out of pocket totals to prepare for collections slowing down in Q1 while collecting out of pocket amounts

  • Run reports to benchmark metrics (utilization, revenue cycle, denials) so you start the new year with clarity.

  • Review software / workflows to ensure readiness for any policy or payer changes.

Common Pitfalls & How to Avoid Them

• Waiting too late on insurance renewal / contract negotiations. 

  • Start early. Some contracts require notice or renegotiation months ahead.

• Overlooking hidden costs or changes in policy details.

  • Not just premiums, but what’s covered, what’s not, reimbursement delays, credentialing requirements.

• Neglecting staff-oriented planning.

  • If staff schedules, benefits, or time off aren’t considered, operations can suffer around the holidays.

• Failing to document changes.

  • When software, policies, or payer rules change, make sure workflows and staff training keep pace.

What You Can Do Now: Your Mini Action Plan

1. Choose one high-impact area (e.g. claims backlog, insurance renewal) and assign it to a team member to lead.

2. Hold a brief meeting with your leadership / billing / clinical teams to map out what needs to happen before December.

3. Set up 2026 baseline metrics so you have something to measure from day one.

4. Begin drafting or reviewing any client communications about holiday schedules or service changes.

Preparing for year-end doesn’t have to be overwhelming, when you break it into manageable steps, it becomes an opportunity: to clean up, to reflect, to plan better, and to build momentum early.

At Ārohana Support, we’re here to help with billing, credentialing or to add additional operational support where it fits best. If you want a hand with any of the items above, or just want to bounce ideas for your 2026 goals, we’d love to support you.