How to Prepare for Patient Insurance Verification Challenges Next Year

By Blakely Roth | November 5, 2025

Patient payments are in flux headed into the new year. Strong insurance verification process will remain critical to financial health. Beyond normal, end-of-year insurance changes for individuals across the nation, other recent reports highlight profit and payment struggles… 

• 56% of practices report delayed payments driven by extended A/R cycles

• Nearly 50% of insured patients fail to pay their out-of-pocket medical bills on average

• 25M people are set to be impacted by Medicaid disenrollment 

• 20% of privately and publicly insured patients face coverage changes each year 

Patient insurance records are more unstable than ever. Medicare coverage changes, Medicaid disenrollments and constant payer updates mean practices will be left scrambling at the front desk to ensure accuracy around patient insurance details. Without a solid verification strategy, billing stalls, write-offs and higher denial rates are inevitable.  

Common and New End-Of-Year Challenges Ahead

1. Ongoing Coverage Shifts

Up to 20% of privately and publicly insured patients face coverage changes each year. For practices, that translates to mounting errors at intake, bad debt accumulation and an uphill battle to ensure data is current.

As regional VP of Comprehensive EyeCare Partners (CompEye), Chad Jackson, recently shared in a revenue discussion, “The biggest challenge in healthcare is eligibility verification… knowing what plan a patient is on, and knowing we have the right information to collect accurately before the visit.” 

2. Denials That Cut into Cash Flow

Nearly 40% of providers say they still struggle to collect accurate intake information. Those data errors trickle downstream, driving denials and revenue leakage. 

3. Pre-Visit Friction for Patients

When patients arrive only to face data discrepancies and long wait times to resolve issues, their experience suffers. In fact, 20% of patients encounter issues before they even see their doctor, creating frustration and longer check-ins. 

Having a Gold-Standard Insurance Verification Approach Matters

These challenges don’t just hurt collections—they ripple through the entire patient journey and practice operations: 

• Billing stalls from inaccurate or missing insurance data 
• Prior authorization delays that disrupt care and time-to-payment 
• Bad debt and write-offs that weaken financial stability 
• Staff overload as teams manually chase down coverage detail and fix last-minute issues 
• Long wait times as staff work to resolve challenges

Medicare cuts and Medicaid churn will only magnify the issue next year. Practices must secure real-time clarity around patient coverage, rather than chase down problems and patients after the fact. 

How to Prepare for the Payment Storm Ahead

1. Automate Verification from the Start

Use the eligibility verification tools that large-scale healthcare practice leaders stand by. Solutions that run before patients arrive—both during online scheduling and at pre-registration. This step ensures coverage changes are flagged immediately, and patients can update their insurance in real time and staff can work ahead on any discrepancies.

2. Empower Staff with Action-Driven Dashboards

Equip teams with a real-time dashboard that highlights pre-appointment errors, so staff focus only on critical actions. For example, Clearwave’s one-of-a-kind dashboard helps staff manage patient check-in, eligibility verification and overall appointment preparedness. It gives staff the power to track and manage pre-verification steps, prior-authorization status and much more—all in one place—preventing issues from spilling into the check-in and claims processes.

3. Streamline Prior Authorizations

Integrate eligibility checks with prior authorization workflows to avoid delays before exams and procedures. Practices that adopt this approach reduce denials and accelerate collections. 

4. Collect at Time of Service

With accurate insurance coverage data upfront, practices can set clear expectations and collect at check-in—a critical step when nearly half of patients fail to pay bills after care. 

Proof in Action 

Clearwave clients are already turning instant verification into a revenue advantage. In this conversation, Automate to Accelerate: Booking, Reminders & Revenue on Autopilot, Chad Jackson shares the success their seeing across CompEye locations:

• Texan Eye: Time-of-service collections jumped from 35% to 89% after launching kiosks—a 154% increase in collections before care. First-pass denial rates dropped 63%, down to just 3% on average. 

• CompEye Members: Achieve 74–100% co-pay collection rates at check-in. Regional VP Chad Jackson notes: “We’ve seen an uplift in the amount of money we’re able to collect at time-of-service, and these tools have helped us reduce our first-pass denial rates.” 

Try Clearwave’s Gold-Standard Insurance Verification Tools

Heading into next year, practices can’t afford to treat insurance verification as an afterthought. With payer churn, rising bad debt and patient financial strain, leaders must shift verification upstream. By adopting real-time, automated solutions, practices can: 

• Reduce denial rates 

• Increase accurate time-to-service collections 

• Lighten staff workloads 

• Deliver a smoother patient experience 

Verification isn’t just an operational task—it’s the foundation of financial health and patient trust in the years ahead. See how Clearwave Eligibility works with an interactive demo!