End-of-Month Billing Checklist

Effective month-end billing close begins a week before the last day of the month. During this preparation phase, your primary goal is to identify and resolve any outstanding items that could delay your close process. Start by running the Unsigned Notes report to identify any session notes from the current month that have not been signed. Send reminders to the responsible clinicians with a deadline of at least two business days before month-end. Unsigned notes cannot generate billable charges, and chasing documentation after the month closes extends your billing cycle unnecessarily.

Next, review the Authorization Status report to identify any clients whose authorizations are expiring at month-end or whose remaining units are critically low. For expiring authorizations, verify that re-authorization requests have been submitted. For low-unit situations, communicate with clinical staff about remaining session availability so they can plan accordingly and avoid delivering services without authorization coverage.

Finally, review any open items from the previous month's close that may still be outstanding. This includes pending corrected claims, appeals awaiting response, and patient balance collection efforts. Clearing these carryover items before the new month's close prevents your open items list from growing unmanageable. Create a task list for each item with an assigned owner and deadline so nothing falls through the cracks.

On the last business day of the month and the first few business days of the new month, focus on capturing all remaining charges and submitting final claims. Begin by running the Session Completion report filtered for the closing month. This report shows every scheduled appointment for the month alongside its documentation status: completed and signed, completed but unsigned, cancelled, or no-show. Any completed sessions without signed notes should be escalated immediately.

Once all notes are signed, review the Unbilled Charges queue for any charges from the closing month that have not yet been included in claims. Verify each charge for accuracy, resolve any flagged issues, and generate claims. Submit these claims through the clearinghouse along with any corrected claims that were held during the month. The goal is to have all claims for the month submitted within the first five business days of the new month.

Also review and post any pending ERAs and EOBs. Payment posting should be current through the last day of the month so your financial reports accurately reflect the month's activity. If you receive paper EOBs that have not been entered, prioritize those during the close process. Record any manual adjustments needed, such as write-offs for uncollectable balances or contractual adjustments that were not captured through ERA auto-posting.

After all charges are captured, claims are submitted, and payments are posted, the final phase of month-end close is reconciliation and reporting. Start with bank deposit reconciliation by comparing the payments posted in PracticeABA for the month against the deposits recorded in your bank account. Investigate and resolve any discrepancies. Common causes include payments received near month-end that post in the following month, clearinghouse processing delays, or ERA files that were received but not yet posted.

Generate the standard monthly financial reports for management review. These typically include the Monthly Revenue Summary (total charges, payments, and adjustments), the Accounts Receivable Aging Report (current AR balance by aging bucket), the Payer Performance Report (collection rates and denial rates by insurance company), and the Provider Productivity Report (sessions, charges, and collections by clinician). PracticeABA can generate all of these reports with a single click from the Month-End Reports section.

Finally, document any issues encountered during the close process and any items that are carrying over to the next month. Create a brief close summary that notes the total charges for the month, total collections, any significant variances from budget or prior months, and action items for the coming period. This summary becomes a valuable reference for tracking your practice's financial trajectory over time and for communicating financial performance to practice leadership. Store the close summary and supporting reports in the Files section of PracticeABA or your practice's document management system for easy retrieval during audits or year-end reviews.