How to Clean Up Your Care Plans, Billing Records, and Authorizations Before the Year Ends

Your Q1 will only be as smooth as your Q4 wrap-up.

The end of the year can feel like a sprint to the finish—but for Medicaid-based care agencies, it’s more like a tightrope walk between closing the books and staying compliant. Whether you support home care, IDD services, or personal care programs, one thing is clear: a messy Q4 leads to a chaotic Q1.

The good news? With a focused approach in December, you can clean up the operational clutter that slows down teams in January. Here’s how to tackle the three most common trouble areas—care plans, billing records, and authorizations—before the year ends.

1. Refresh and Reconcile Care Plans

Care plans are often the first thing auditors request—and one of the most common sources of compliance risk. Outdated, unsigned, or expired care plans can block billing, trigger denials, or flag your agency for further review.

Use this checklist:

• Confirm that all active clients have a current, signed care plan on file.

• Check expiration dates and schedule reassessments for plans expiring in Q1.

• Ensure the care plan aligns with authorized services and scheduled hours.

• Store plans in a central, accessible location (preferably within your EMR).

Tip: Run a care plan audit by program or payer. Prioritize Medicaid clients with the most visits or high-acuity needs.

2. Clean Up Billing Records and Outstanding Claims

Closing out the year without reviewing your billing pipeline is like leaving money on the table. Unsubmitted or rejected claims from Q3 and Q4 can snowball into cash flow issues if not caught now.

What to do before January:

• Identify claims that are incomplete, rejected, or waiting on documentation.

• Resubmit corrected claims before payer cutoff deadlines.

• Confirm that visits match active authorizations and have EVV data attached.

• Reconcile outstanding balances by payer and flag recurring denial patterns.

Tip: If your software doesn’t flag visits that can’t be billed, consider that a red flag. Manual tracking creates unnecessary risk.

3. Review and Renew Expiring Authorizations

Nothing kills productivity in January like discovering that half your visits aren’t billable due to expired authorizations. Even worse—your care team may deliver services they can’t be reimbursed for.

Steps to take now:

• Run a report of all active authorizations by end date and payer.

• Identify clients with authorizations expiring in the next 30–60 days.

• Submit renewal requests early to avoid holiday-related processing delays.

• Confirm unit limits vs. scheduled visits to avoid overages.

Tip: Assign one team member to “own” authorization tracking—even if you use automated tools. A human layer of oversight goes a long way.

Set Q1 Up for Success—Not Stress

The providers who get ahead now won’t just avoid backlogs and billing delays—they’ll start the year with confidence, clarity, and clean data.

At Statewise, we help Medicaid agencies streamline operations, prevent documentation errors, and automate the workflows that matter most. Because starting strong in January begins with how you finish in December.