End-of-Year Revenue Cycle Cleanup: The Six Reports Every Practice Should Run Before December 31

Before the calendar flips, six revenue cycle reports separate a clean Q4 close from a Q1 surprise. Each one takes under an hour with a halfway-decent analytics setup and recovers far more than that in identified issues.

1. Days in AR by payer, last 90 days

Look at days-to-payment by payer for the trailing 90-day window. Compare to the same window a year ago. Any payer that slipped more than 5 days needs an account check before year-end — that's usually a contract change, a new prior-auth requirement, or a clearinghouse routing issue that'll compound through Q1 if you don't catch it now. The healthcare benchmark for clean claims is 40-45 days; over 55 is a problem worth investigating.

2. Denial rate trend by CARC code, year-to-date

Pull denials by CARC code, year to date. Look at the top five — they almost always account for 50-70% of denial dollars. If CARC 197 (precertification absent) is climbing, you have a front-end issue. If 16 (claim/service lacks information) is climbing, you have a documentation issue. The two get fixed in completely different places. See the five denial codes that account for 60% of lost revenue for the deep version.

3. Charge lag analysis

How many days between service date and charge entry? Best-in-class is under 2 days. Each additional day of charge lag pushes a claim into a later cycle and compounds AR aging. The Q4 view: what's the distribution of charge lag by provider and by service line? Outliers usually represent a workflow gap that's about to become a 2026 budget issue.

4. Unbilled claims aging

Encounters that were closed clinically but never billed. These should be near zero. A persistent unbilled tail usually means a coding queue that's backed up, a missing modifier that's kicking encounters into “needs review,” or a downstream system integration that broke quietly. Year-end is the time to find them — by Q1 the documentation is colder and harder to fix.

5. Provider E&M distribution vs national benchmark

For each provider, the distribution of 99212, 99213, 99214, 99215 visits — by specialty. Compare to CMS national benchmarks. Outliers in either direction are interesting:

• Heavy 99213 with low 99214 distribution usually means systematic undercoding — provider documenting more than they bill.
• Heavy 99214/99215 without supporting documentation is audit exposure.

The undercoding case is more common and more recoverable. See why your E&M distribution is probably wrong.

6. Net collection rate by payer

Of every dollar billed to a payer, what fraction did you ultimately collect? Best-in-class is 96-98%. Anything below 92% is a contract or workflow problem. Year-end is when payer mix and contract performance should be reviewed for the upcoming renewal cycle.

Why these matter together

The six reports above answer six different questions, but they often point to the same root cause. A new payer policy that started in October will show up in days-in-AR, in CARC-197 denials, and in net collection rate. Running the reports in isolation misses the pattern. Running them together — ideally in the same analytics layer — surfaces the cause behind the symptoms.

Vizier's revenue cycle workflow ships with all six of these pre-built. Connect your billing system or EHR via a direct connector, and the year-end review takes an hour instead of a week.