Open Enrollment Season: Why Now Is the Time to Talk Insurance with Your Clients

Oct 30

Every fall, behavioral health practices face an important, yet often overlooked opportunity: open enrollment season. Between mid-October and early January (depending on the plan type), clients across the country can review, renew, or change their health insurance coverage.

For practice owners, this season is more than just a paperwork headache; it’s a chance to help your clients make informed decisions, protect your revenue stream, and prevent future billing and eligibility issues.

Let’s look at why now is the time to start talking insurance with your clients and how your practice can navigate open enrollment smoothly.

1. Avoid Coverage Gaps That Disrupt Care

If your clients’ insurance changes (or lapses) without your team realizing it, you could face denied claims, unexpected patient balances, or even treatment interruptions.

During open enrollment, encourage clients to:

Check if their plan is renewing automatically or if they need to re-enroll.
Confirm that your practice remains in-network with their chosen plan.
Bring in or upload their new insurance cards as soon as they receive them.

These small steps can prevent major disruptions in care continuity come January.

2. Help Clients Understand Their Options

Behavioral health coverage varies widely across plans. Many clients don’t fully understand their mental health benefits, or that switching plans might mean losing access to their current provider.

Take a few minutes during sessions or in a client newsletter to remind them:

Behavioral health coverage differs between Marketplace, employer, and Medicaid plans.
Some plans require new authorizations or referrals for ongoing therapy.
Telehealth rules and copays can change when plans renew.

You don’t need to be their insurance advisor, but a quick reminder to review these details can make a big difference in your clients’ access to care.

3. Update Your Practice Records

Even if your clients’ coverage doesn’t change, their policy ID numbers or plan administrators often do.

Be proactive by:

Sending a secure client portal message or email blast asking clients to update insurance details before January.
Verifying eligibility and benefits for all active clients in December.
Training front-desk or billing staff to flag mismatches between old and new plan information.

Clean records help your billing run smoothly and maintain a steady cash flow.

4. Communicate Early and Often

Open enrollment is a great time to demonstrate your practice’s professionalism and care for your clients. A few simple communication ideas:

Post reminders in your waiting room or client portal.
Add a note to your email signature: “It’s open enrollment season, don’t forget to update us if your insurance changes!”
Mention it in your session check-ins during November and December.

By normalizing the conversation, you make it easier for clients to share changes right away, before billing issues arise.

5. Prepare Your Billing Team (or Partner)

This time of year can be one of the busiest for billing departments. If you manage your billing in-house, ensure your team has time set aside in December to run eligibility checks and update payer information.

If you outsource billing, let your billing partner (like BreezyBilling!) know of any major client or insurance changes as early as possible. Accurate information ensures clean claims and faster payments.

Open Enrollment Details to Consider:

Marketplace Plans (Individual/Family): Open enrollment runs Nov 1–Jan 15 (check your state’s deadline—some vary).
To start coverage by Jan 1: Enroll by Dec 15 (in most states); enroll later and coverage likely begins Feb 1.
Employer-Sponsored Insurance: Open enrollment periods vary—confirm with your HR department or payer; they may not follow the federal schedule.
Other Coverage (Medicare, etc.): These programs have separate enrollment windows—review their timelines carefully.

Final Thoughts

Open enrollment season is an important time for the financial health of your practice and the well-being of your clients.

By starting the conversation now, you can reduce denials, protect continuity of care, and build trust with clients who see that your practice truly has their best interests in mind.

At BreezyBilling, we help behavioral health providers stay organized year-round, so your billing doesn’t get blown off course when insurance seasons change.

Need help staying on top of insurance updates and eligibility checks?
Reach out to BreezyBilling today to learn how we can make your billing smoother, faster, and stress-free.