How to Prepare for Patient Insurance Verification Challenges Next Year

By Blakely Roth | November 12, 2025

Patient payments are in flux headed into the new year. Having a strong insurance verification process will be critical to financial health. End-of-year insurance changes for individuals across the nation indicate potential payment struggles for providers, patients and practices… 

• 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 

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

Patient insurance and data are more unstable than ever. Medicare coverage changes, Medicaid disenrollments and constant payer updates mean practices will be left scrambling at the front desk. Without a solid verification strategy, billing stalls, write-offs and higher denial rates are inevitable. See how to ensure your insurance verification process can withstand these shifts! 

End-Of-Year Patient Insurance Challenges Ahead: New & Common Setbacks

1. Ongoing Coverage Shifts

Up to 20% of privately and publicly insured patients face coverage changes each year. For practices, that shift translates to mounting errors at intake, higher potential for increased bad debt accumulation and an uphill battle to ensure accurate patient data. Regional VP of Comprehensive EyeCare Partners (CompEye), Chad Jackson, recently shared his take on how practices can prepare. 

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 ongoing revenue leakage. Practices must put in the roadblocks prior to patient visits to reduce downstream errors and revenue stalls. 

3. Pre-Visit Friction for Patients

When patients arrive only to face data discrepancies, the experience suffers. In fact, 20% of patients encounter issues before they even see their doctor, creating frustration and longer check-ins. Avoid patient frustration by rethinking your pre-visit insurance verification approach. 

Why a Gold-Standard Insurance Verification Approach Matters

Medicare cuts and Medicaid churn will only magnify the above issues next year. Practices must secure real-time clarity around patient coverage to avoid chasing down insurance-related problems after the fact. These challenges don’t just hurt collections—they ripple through the entire patient journey, creating frustration all-around: 

• 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 
• Angry patients who face unexpected charges or long check-in times, impacting provider interactions and retention

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—ideally both during online scheduling and at pre-registration. Early insurance checks and data-update prompts for patients will ensure coverage changes are flagged immediately, and patients can update their insurance data ahead of time. 

2. Empower Staff with Action-DrivenDashboards 

Equip teams with an easy-to-use, all-patient eligibility dashboard that flags errors and discrepancies, meaning staff hone in on critical pre-appointment actions, rather than go patient by patient. 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 process. Dive deeper.

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 the Time of Service

With accurate insurance coverage data upfront, practices can set clear expectations and collect at check-in, rather than sending bills for cop-pays after they’ve come in for care. This collection step will be key to reducing bad debt next year, especially when nearly half of today’s patients fail to pay bills after care. 

Proof in Action

Clearwave clients are already turning insurance 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 including: 

• 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 Suite

Heading into the new 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!