3 Tips to Prepare for Patient Insurance Changes in the New Year

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Every provider wants their medical practice to hit the ground running in the new year, but unforeseen billing issues can stall your plans. During 2021 open enrollment, 45% of Americans were considering changing their insurance plans, and 4.6 million Americans have signed up for health insurance coverage on Healthcare.gov or their state’s marketplace in that period. As such, it is rather likely that some of your patients will be covered under a different insurance plan than the last time they saw you.

As the calendar turns over, it is important to prepare for changes to your patients’ insurance that could affect your medical billing process. Did their deductibles reset? Are they covered under the same plan as the last time they saw you? These are the kinds of questions you need to get in front of if you want a seamless transition into the new year.

To help your medical billing team prepare for these changes, we spoke with DrChrono’s Director of RCM (revenue cycle management), Tiffany Wells, to learn more about what she would advise practices to do in this situation. Here are her top three tips to prepare for patient medical insurance changes in the new year.

Send a Mass Email to Patients

The best first defense against a new year’s billing pileup is sending out mass communications to your patients, so that you’ll cast as wide a net up front as possible.

“Sending out a mass email to all patients to make sure that they update your practice and bring in a copy of their insurance card at their next visit is a great starting point for practices,” said Wells.

This is a quick way to catch the attention of a large number of your patients to hopefully ensure they come prepared to their next appointment. You can send out emails manually, which may take some more time, or you can automatically send out a mass email through your EHR to speed up the process.

Check Previous Appointments

Sending that mass email is a great way to reach many of your patients, but over the holiday season, it’s likely to get buried in patients’ inboxes. As another safeguard, make sure that you or your administrative staff are paying attention to previous appointment billing information when patients call to schedule new appointments.

“As patients are calling in to schedule future appointments, it’s a good idea to check the patient’s last appointment. If their last appointment was in the previous calendar year, you can ask the patient for their updated insurance information over the phone. Then you can verify their eligibility in real time, so that you have updated registration prior to the visit,” Wells mentioned.

Real-time eligibility checks in your EHR system will prove to be a nearly essential feature during this time of year. Without that tool, your staff could potentially be bogged down by phone calls to insurance companies in an effort to confirm insurance eligibility for your patients.

Be Mindful of Medicare Statuses

For medical practices that see Medicare patients, there may be some extra hoops to jump through to confirm the patients’ eligibility statuses.

“Be careful when checking benefits for Medicare patients. Medicare will respond with an “active” status even if the patient has a Medicare HMO. Be sure to check the ‘other or additional payer’ section on the eligibility return,” said Wells.

This quick extra step could potentially save you significant time later on, so make sure to be particularly thorough when entering or verifying Medicare insurance information. This will also make it easier for your patients to pay what they owe while getting the proper assistance from their insurance provider.

Transitioning into the new year is an exciting time full of possibilities, and with it comes plenty of change as well. However, your practice can prepare itself for an early wave of new patient insurance plans via mass communications, checking previous appointments for insurance information and making sure that you are paying extra attention to Medicare coverage statuses.