Get Your Practice Ready for 2026: The Ultimate New Year Billing Checklist

As the holiday season draws to a close, now is the perfect time to prepare your practice for a successful 2026. The New Year is an opportunity to reflect on the past and make changes that will improve your revenue cycle management, reduce claim denials, and ultimately boost your bottom line. Whether you’re a solo practitioner or part of a larger healthcare team, setting up strong billing practices today can ensure smoother operations in the year ahead.

As we step into 2026, healthcare practices face a new set of challenges and opportunities in revenue cycle management. This blog will guide you through a comprehensive New Year’s billing checklist that will help optimize your billing process, improve efficiency, and set achievable goals for the year ahead.

The Ultimate Billing Checklist for 2026

Below is a checklist you should review before ringing in 2026 to help keep your billing process efficient and compliant:

1. Review Insurance Contracts

Are all your payer contracts updated? Ensure that your reimbursement rates and payment terms are up to date. Take time to review any changes that may have occurred in the past year and confirm that they are reflected in your billing system.

2. Verify Coding Accuracy

Ensure that all coding for procedures, diagnoses, and services aligns with the latest updates (like ICD-10, CPT, and HCPCS codes). Inaccurate coding can lead to claim denials and delayed reimbursements, so it’s essential to stay on top of these updates.

3. Check Your Billing Software

Is your billing software up-to-date? Ensure that your billing platform is running on the latest version and is fully integrated with your practice management system. Automation and efficiency are key, so using the right technology is crucial for success.

4. Perform a Financial Health Check

Review your revenue cycle performance from the past year. Check for patterns of late payments or recurring claim denials and take action to address the root causes.

5. Staff Training and Education

Ensure your billing team is trained on the latest coding changes, payer policies, and best practices. Invest in continuous education to improve accuracy and efficiency.

6. Set Collection and Payment Goals

Set clear, achievable goals for improving collections and reducing outstanding patient balances. Establish a system for follow-up and automated reminders for patients with outstanding balances.

What Are the Upcoming Changes in Billing Policies for 2026?

As healthcare evolves, so do billing policies and regulations. In 2026, there are several key changes you need to be aware of to stay compliant and ensure smooth reimbursement cycles. Here’s a glimpse of the upcoming changes in billing policies:

1. New ICD-10-CM Code Updates

The ICD-10-CM code set is updated annually. For 2026, expect additional code revisions that reflect new medical conditions, procedures, and advancements in healthcare. Ensure your practice updates its systems to accommodate these new codes to avoid claim rejections due to outdated codes.

2. Value-Based Care and Payment Models

More healthcare providers will see increased pressure to adopt value-based care models in 2026. These models incentivize providers based on patient outcomes, not the volume of services rendered. Practices will need to improve documentation and accuracy in billing to track and report on patient outcomes effectively.

3. Changes in Medicare and Medicaid Reimbursement Policies

Medicare and Medicaid reimbursement policies are expected to undergo further adjustments in 2026. This may include new payment structures, including bundled payments for certain procedures and expanded eligibility criteria for coverage. It’s important to stay updated on these changes to avoid underpayments or denials.

4. Increased Focus on Compliance and Audits

As healthcare providers continue to face pressure to comply with regulations, the risk of audits will increase in 2026. Practices must be diligent about following all billing guidelines, from coding to documentation, to avoid penalties. Proper training and regular internal audits will be critical to staying compliant.

5. Expansion of Telehealth Reimbursement

The reimbursement for telehealth services is expected to expand in 2026, with more insurance providers covering telehealth visits as standard practice. However, billing for telehealth services will require specific codes and documentation. Make sure your practice is ready to handle telehealth billing efficiently.

By understanding these policy changes early, you can better prepare your practice for a smooth transition into 2026. Cloud RCM Solutions can help you stay on top of these updates and implement changes in your billing process to maintain compliance.

Strategies for Setting New Year Billing Resolutions

Now that you have your checklist and are aware of the upcoming changes, it’s time to set New Year billing resolutions that will help your practice grow and thrive in 2026. Here are some key goals you should consider implementing:

1. Reduce Claim Denials

Work to reduce claim denials by improving coding accuracy and streamlining your submission process. Consider investing in software that provides real-time error checking to catch mistakes before they delay payments.

2. Automate Key Billing Functions

Automate recurring billing tasks like payment reminders, claim follow-ups, and patient invoicing to save time and reduce the risk of human error. Leveraging technology will improve your efficiency and free up staff to focus on higher-value tasks.

3. Improve Patient Payment Collections

Set clear payment expectations with patients from the start and implement easy-to-use payment portals or plans to help them manage their bills. Clear communication can reduce delays and improve cash flow.

4. Optimize Your Payment Cycle

Aim to reduce your average days in accounts receivable (AR). Identify any bottlenecks in your payment process and address them. For example, streamlining claims submissions or working with payers to reduce delays can significantly improve cash flow.

CMS Updates You Need to Know for 2026

As a primary body overseeing Medicare and Medicaid, CMS is introducing key updates in 2026:

• Medicare Payment Changes: Medicare will adjust reimbursement rates under the Physician Fee Schedule (MPFS), affecting various services. Stay informed to ensure proper billing for services provided.
• Quality Reporting Expansion: CMS is expanding MIPS (Merit-Based Incentive Payment System) and APMs (Alternative Payment Models). Practices must meet more rigorous reporting standards, or face potential penalties.
• Medicaid Coverage Updates: Expect new coverage guidelines for Medicaid, especially for telehealth services, outpatient care, and preventive treatments. Ensure your practice complies with these changes to avoid billing errors.
• Telehealth and Remote Monitoring: CMS will broaden its coverage for telehealth and remote patient monitoring (RPM), with new codes for these services. Prepare your practice to handle these changes for seamless billing.
• Increased Audit Risk: CMS is ramping up audits in 2026 to ensure providers are compliant with billing rules. Prepare your practice by ensuring proper documentation and auditing your own processes regularly.

How Cloud RCM Solutions Can Help You Achieve Your 2026 Billing Goals

As you look to implement these resolutions and prepare for the upcoming changes, remember that Cloud RCM Solutions is here to help you. We specialize in end-to-end revenue cycle management services, offering a range of solutions designed to streamline your billing process and boost your financial health.

Here’s how partnering with us can support your New Year’s resolutions:

• Comprehensive Billing Services: From coding accuracy to claims submission, we ensure that every part of your billing process is optimized for maximum efficiency.
• Advanced Technology: Our state-of-the-art billing software helps reduce errors, automate tasks, and speed up your reimbursement cycle.
• Expert Support: Our experienced team of medical billing professionals is always available to answer your questions and provide customized advice tailored to your practice’s unique needs.
• Compliance and Accuracy: We stay up-to-date with all the latest regulations and coding changes to ensure your practice remains compliant and your claims are processed without delay.

Why Now Is the Time to Take Action

The holiday season may be a time for rest, but it’s also the perfect time to reflect on the year ahead. Don’t wait until the last minute to prepare for 2026, now is the time to review your processes, set your resolutions, and take action to ensure your practice thrives in the New Year.

By implementing the New Year billing checklist and setting achievable resolutions, you’ll position your practice for improved financial performance and operational efficiency.

Final Thoughts:

Ready to make 2026 your best year yet? Cloud RCM Solutions is here to support you with customized billing solutions and expert services to help you meet your goals.

Contact us today to schedule a free consultation and start planning your practice’s billing strategy for 2026. Let’s work together to reduce denials, streamline your process, and maximize your reimbursements.
Get started today and take advantage of our exclusive offer for new clients 10% off your first three months of billing services.

Don’t wait – let’s make this year your most efficient, profitable, and stress-free year in billing!