Articles

Preparing for Q4 Collections: Strategies for Health Systems to Maximize Recoveries Now

Oct 23, 2025

Healthcare revenue cycle management is critically important throughout the year; however, it’s particularly vital during the fourth quarter—a time when many health systems strive to meet year-end targets, use up remaining annual budgets, calculate performance-based bonuses, and prepare for the new fiscal year. One healthcare financial management challenge? Self-pay accounts receivable (AR) and outstanding balances tend to accumulate during Q4 due to payer and provider administrative bottlenecks as patients rush to use remaining benefits. That’s why it’s critical for health systems to optimize healthcare collections as early in the quarter as possible. In this article, we’ll provide practical, tactical revenue cycle management strategies to maximize recoveries immediately. 

5 Strategies for Successful Healthcare Collections in Q4 and Beyond 

The following five healthcare financial management strategies can help revenue cycle management and finance professionals boost healthcare collections and financial performance heading into the New Year: 

 

1.   Assess current healthcare AR. The goal is to gain a real-time window into organizational liquidity, billing performance, payer relations, and patient financial behavior. Here’s what you’ll need to do:

 

  • Analyze aging healthcare AR reports. Segment unpaid accounts into these three buckets: Self-pay, insurance denials, and charity eligible.  
  • Perform insurance discovery on straight self-pay accounts. Determine whether ‘self-pay’ patients have insurance coverage that may apply. Also consider doing this for patients with billable balances after insurance pays the claim to determine whether secondary coverage exists. In some cases, patients marked as ‘uninsured’ may have coverage that only a revenue cycle management insurance discovery scrub can identify. However, be mindful of timely filing limits to avoid denials. 
  • Tailor healthcare collection strategies. Self-pay, insurance denials, and charity-eligible accounts differ in terms of root cause, collectability, regulatory constraints, and patient impact. For example, health systems may want to pursue self-pay balances using installment plans and low complex insurance denials using automated appeals. Then reclassify eligible bad debt cases as charity care before writing those balances off. 
  • Identify, address healthcare collection bottlenecks. Highlight areas where internal revenue cycle management processes may delay healthcare collections (e.g., missed follow-ups or outdated contact information). Strive to reduce care gaps and update demographic information for accuracy and effective healthcare financial management.  

 

2.   Engage patients proactively. Early, next level patient engagement is important in revenue cycle management because it prevents surprise bills, builds trust, increases the likelihood of payment, and improves healthcare financial management. Here’s how to do it:

 

  • Communicate balances clearly. Send reminders and statements early in Q4 to remind patients of their outstanding balances and how to pay. 
  • Leverage patient portals. Use digital platforms for healthcare financial management that allow patients to view balances, make payments, and set up payment plans. 
  • Offer flexible payment options. Promote payment plans and financial assistance programs to encourage timely payments and reduce healthcare AR. 
  • Perform personalized outreach. Use call center staff trained in empathic healthcare collections or automated outreach to contact high-balance patients directly.  

 

3.   Optimize internal healthcare collections processes. Effective revenue cycle management is about ensuring that every billed dollar has the best possible chance of being collected efficiently, compliantly, and compassionately. Here’s what to do internally to improve healthcare AR:

 

  • Automate reminders and alerts. Use billing software to trigger follow-ups on past-due balances. 
  • Collaborate with financial counselors. Integrate financial counseling teams into the healthcare collections process for patients who need support regarding healthcare financial management. 
  • Consider ‘paid in full’ discounts. For example, a 10% discount that accelerates $1M of 90-day A/R into 30-day collections could improve cash flow by $900K and reduce bad debt expense by $100K. However, be sure to decide up front which balances qualify, when the discount applies, and how much you will discount the bill. Also ask for a legal review to ensure compliance with Medicaid, Medicare, and commercial plans. For example, many managed care contracts prohibit offering discounts beyond negotiated rates or they require parity with payer rates. In addition, for federally insured patients, you cannot routinely discount patient responsibility. Discounts must be non-routine and non-inducement based per the Anti-Kickback Statute and Civil Monetary Penalties law. Once approved, promote the discount using dialer messaging, statement inserts, and email/SMS campaigns. 
  • Deploy staff effectively. Assign high-value, complex accounts to experienced healthcare collections staff for more effective resolution.  
  • Intervene early. Address healthcare AR accounts that are trending toward delinquency before they become harder to collect. 
  • Streamline workflows. Ensure alignment between billing, insurance verification, and healthcare collections teams to avoid redundancy and improve revenue cycle management efficiency and consistency. 

 

4.   Leverage technology and analytics. Leveraging technology and analytics is all about turning data into actionable revenue cycle management intelligence. To promote effective healthcare financial management, use the following:

 

  • Artificial intelligence (AI)-assisted engagement tools. Implement AI-assisted tools that reduce staff burden by automating healthcare collections reminders, email follow-ups, or text notifications. 
  • Dashboard monitoring. Track key Q4 metrics such as healthcare AR days, healthcare collections rates, and healthcare AR delinquency trends in real time. 
  • Integrated reporting. Ensure healthcare AR, billing, and patient engagement platforms are synchronized for accurate tracking and timely decision making. 
  • Predictive analytics. Identify patients most likely to pay with additional outreach or payment plans. 

 

5.   Prepare for year-end compliance and reporting. In summary, preparing for year-end reporting requires these four critical healthcare financial management actions:

 

  • Audit self-pay AR to confirm balances and reduce healthcare AR disputes. 
  • Prepare financial dashboards to depict a clear picture of revenue cycle management recoveries and outstanding balances before year end. 

 

Q4 is a critical time to optimize healthcare collections and improve financial performance. Combining patient engagement, optimized internal processes, and analytics-driven decision making can maximize recoveries, so health systems finish the year strong and position themselves for success in the new fiscal year. Contact Revenue Enterprises for additional expert guidance on Q4 healthcare collections strategies, healthcare AR optimization, and patient engagement solutions. 

Karie Bostwick

VP of People and Compliance

As VP of People and Compliance at Revenue Enterprises, Karie Bostwick oversees People functions including recruiting, training, onboarding, engagement and satisfaction. Additionally, she is responsible for compliance training, oversight and monitoring.

Karie has a long history of working in the revenue cycle support industry. Her skills span leadership, operations start up, policies and procedures development, operations workflow, budgeting and client management.

She is passionate about the experience of our people, patients and the Healthcare clients we serve and believes that a team of diverse, talented and motivated individuals working together toward a common goal can make a difference.

Robert Sterett

VP of Information Technology

As a transformational leader Robert Sterett has leveraged his 20 years of experience to build effective service lines and exceptional teams. In his role as VP of Information Technology at Revenue Enterprises, Robert excels at taking a unique, balanced, and strategic approach to technology leadership with people first for the best possible outcome. Using his experience from engineering, project management and service line management he takes a multi-faceted approach to ensure the right people are in the correct position coupled with the best technology to meet or exceed all expectations from security to compliance and business continuity.

Robert’s leadership style lends itself to building long term relationships and has consistently been a relied upon strength in many organizations. Over Robert’s time as an IT operational and project leader, he has spent significant time in both hands-on technology facing roles and client centric management roles to bring the best solutions that strive to meet the business and client needs.

Focusing heavily on his personal development skills and opportunities, Robert continues to foster coaching and mentorship relationships everywhere in his life, and the lives around him.

Douglas Dunbar

VP of Sales & Marketing

As VP of Sales and Marketing for Revenue Enterprises, Douglas Dunbar leads with a passion for building strategic partnerships, nurturing relationships, and upholding customer service excellence. In his role, Doug focuses on marketing and brand strategy, sales team leadership, and working closely with members of the management team to best serve company goals.

Doug has over 28 years of National sales and marketing call/contact center leadership, with 10 years of service specifically at Revenue Enterprises. Currently, Doug serves as part of Wyoming HFMA Chapter leadership and has held various roles in Colorado HFMA Chapter leadership for over 9 years.

In his spare time, Doug is very family oriented. Additionally, he loves traveling, cycling, golfing, fishing, hunting, and boating.

Kris Brumley, MBA

President & COO

As President & COO of Revenue Enterprises, Kris Brumley is a collaborative partner within the executive team and a leader for operational functions across the organization. Kris productively shares vision, drives innovation, and supports those around her in a way that elevates them and fosters continuous improvement and results. She has helped create a supportive environment for clients resulting in 98% client retention and a 65% NPS score for all clients and 75% for top clients by revenue.

Kris possesses an MBA in data analytics and has twenty-five years of experience in the healthcare industry, with 19 specifically in revenue cycle. She brings a wealth of customer service experience to her role and has worn many hats at Revenue Enterprises including Director of Business Development, EBO Division Director, and VP of Client Experience Management.

In her personal life, Kris is as busy outside of work as inside. She values spending time with her family, and enjoys fishing, hiking, traveling and interior decorating and design.

Timothy (Tim) Brainerd

CEO

As CEO of Revenue Enterprises for almost 20 years, Tim Brainerd leads by example. He promotes a shared vision and stewards a culture of Integrity, Passion, and Respect. He has assembled and empowered high-performing talent and teams to support customers, facilitate strategic planning and manage the capital of the company. Under his leadership, Revenue Enterprises has doubled in size three times over the past fifteen years while maintaining a culture of caring and gratefulness.

Tim has close to four decades of revenue cycle experience, including nineteen years with RSI
Enterprises. He has been a past president of Colorado Chapter of the HFMA and a presenting speaker on the topic of Leadership. He is a fifteen-year member of Vistage International, the world’s largest CEO coaching and peer advisory organization for small and midsize business leaders.

Raised in the Midwest, Tim values humble principles like being respectful, caring, passionate, self-reliant, and most importantly grateful. His most important lesson and the lesson he hopes to pass on in all relationships is living the Golden Rule–do unto others as you would have them do unto you. He is intentional in his choices and believes in making decisions, taking action, being accountable, and loving your neighbors.

Whenever possible, Tim spends his time with his wife of nearly forty years, his adult children, and his grandchildren. His hobbies include fishing, golfing, traveling as well as game nights and sharing great food with his family.