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

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. Staying on top of insurance billing for mental health year-round makes open enrollment transitions much smoother.

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. Coverage gaps are one of the leading causes of claim denials in the new year — catching them before January is far easier than appealing denied claims after the fact.

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 can make a big difference in your clients' access to care. Having a clear way to explain copays and deductibles helps clients make better decisions during open enrollment when they're comparing cost-sharing structures across plans.

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 message asking clients to update insurance details before January
• Verifying eligibility and benefits for all active clients in December — eligibility verification is a core part of revenue cycle management and helps catch issues before they become denials
• Training staff to flag mismatches between old and new plan information

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

4. Communicate Early and Often

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

• Post reminders in your waiting room or client portal
• Add a note to your email signature about updating insurance info
• Mention it during session check-ins in November and December

By normalizing the conversation, you make it easier for clients to share changes before billing issues arise. This is also a natural time to revisit talking to clients about deductibles — many clients' deductibles reset January 1, which affects their out-of-pocket costs immediately.

5. Prepare Your Billing Team (or Partner)

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

If you outsource billing, let your billing partner know of any major client or insurance changes as early as possible. Accurate information ensures clean claims and faster payments. If you're weighing whether in-house or outsourced billing makes more sense for your practice, consider reviewing the hidden costs of in-house billing — open enrollment season often reveals those costs most clearly.

Open Enrollment Details to Know

• Marketplace Plans (Individual/Family): Open enrollment runs November 1 – January 15 (check your state's deadline)
• To start coverage by Jan 1: Enroll by December 15 in most states
• Employer-Sponsored Insurance: Open enrollment periods vary by employer
• Medicare and other programs: Have separate enrollment windows — if you serve Medicare patients, review the Medicare enrollment and participation requirements that apply to your practice

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. Get in touch to learn how we can help.