How Revenue Cycle Automation Can Rescue Your Team From Open Enrollment Headaches

In a season when millions of Americans are selecting new insurance benefits, keeping up with their changes can put a strain on healthcare staff. To continue delivering the high-quality care your patients depend on, reducing that strain is key.

Explore how revenue cycle automation can lighten the workload resulting from coverage changes, help prevent staff burnout, and improve performance in the process.

The real impact of open enrollment on healthcare teams

The insurance coverage changes that stem from open enrollment season create several challenges for billing teams.

Surge in insurance verification workload

Insurance verification is a tedious task at any time of year, but it’s a particularly demanding process at the start of the new year when coverage changes go into effect.

During the 2025 open enrollment season, more than 24 million people selected or were automatically re-enrolled in coverage through the federal Health Insurance Marketplace or state-based exchanges. That’s a 13% increase from 2024 and 49% more than in 2023.

This surge in coverage changes means insurance verification workloads multiply, sometimes by several hours per week.

Burnout from manual processes

Repetitive, low-value tasks are detrimental to employees’ morale.

When performed manually, insurance verification can fall into this category. It’s a cumbersome process requires staff to collect and input patient information, access multiple online portals, and play phone tag with insurance companies — and the steps must be repeated for each form of coverage.

When translated to dozens of patients a day, this takes a toll on your team.

Higher error rates

Trying to handle a heavier workload in the same number of hours can lead to rushed intake and billing. Mistakes — even minor ones — during patient intake contribute to claims denials, which slow down cash flow and create even more work for billing staff.

Where revenue cycle automation can make a big difference

Eligibility checks

In the front-end, revenue cycle automation puts a stop to system-hopping and instantly finds the patient coverage information you need to verify patient eligibility. Save staff time by using batch verification capabilities to check multiple patients and payers at once.

Having complete, accurate eligibility information up front means less scrambling and fewer “Member Not Found” headaches.

Coverage discovery

Similarly, automating insurance discovery ensures that all applicable coverage is found, which is key at a time when patients’ plans are changing and enrollment windows are beginning or ending. With the help of revenue cycle automation, staff can use patients’ demographic data to find undisclosed and unknown coverage as well as key details like their correct Medicare Beneficiary Identifier (MBI).

Plus, making all insurance coverage easily discoverable in one place saves staff hours each week and prevents uncompensated care.

Medicare and Medicare Advantage plan tracking

On top of the standard plan changes that come with open enrollment season, Medicare is undergoing significant shifts. Take the stress out of staying on top of these changes with revenue cycle automation.

Recurring batch checks monitor for plan statuses, secondary payer info, and compliance, giving staff the most up-to-date Medicare Fee-for-Service (FFS) and Medicare Advantage information at their fingertips.

Claims submissions and appeals

Automation doesn’t just minimize errors during intake; it can catch and correct them before a claim is submitted. Pre-validating claims and triggering built-in workflows when intervention is required reduces the burden on staff while helping get more claims paid on the first attempt.

Going a step further, revenue cycle automation helps teams deal with denials in a timely manner by streamlining the process of audits and appeals. Reworking claims takes less time, reducing bottlenecks and preventing lost revenue.

Staff benefits: from burnout to balance

Rescue your team from burnout while boosting business outcomes at the same time by using revenue cycle automation to tackle coverage changes.

Freeing up time spent on repetitive tasks lets staff focus on more engaging work, like serving patients. Staff who are more engaged with their jobs experience lower levels of stress, which can lead to higher morale and greater productivity.

Cutting down the manual steps it takes to get from patient intake to paid claim reduces errors, preventing time-consuming claims rejections and frustrating rework. More accurate claims equal more complete payments in less time.

Getting started with revenue cycle automation

1. Prioritize easy setup

Get up and running quickly by looking for tools that integrate with your current systems. API integrations make it possible to layer new capabilities onto your existing technology, so staff can take advantage of faster workflows without lots of training.

2. Start small

Make an immediate difference by tackling high-impact, low-complexity workflows first.

Eligibility verification and insurance discovery are two great options; automating these processes can save time and make work easier from day one.

3. Be proactive

Open enrollment begins November 1. Medicare is even earlier, starting October 15.

Discover how getting started with Inovalon’s Eligibility Verification Standard™ and Insurance Discovery™ solutions ahead of these important dates can keep coverage changes from throwing your team off track.

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