Key Challenges In Healthcare Revenue Cycle Management

Incentivization plays a key role in furthering growth and making quality services accessible to the masses. The same condition applies to healthcare organizations since even they require profits to continue offering quality healthcare services. But unfortunately, making a profit with a healthcare organization is much easier said than done.

This is where effective healthcare revenue cycle management comes into the picture and to the rescue of healthcare organizations. Unsurprisingly, even revenue cycle management has certain challenges you must dodge to generate better results. So let’s check out some of these healthcare revenue cycle management challenges and find ways to address them.

But First, What Does Healthcare Revenue Cycle Management Mean?    

Healthcare revenue cycle management is an integral process that helps healthcare providers and organizations generate profits. The process starts right from the point when the patient makes an appointment to seek medical services. Furthermore, it ends when the healthcare organization has successfully received the payment from the patient.

However, this process is far more complex and challenging than you might imagine. This is mainly because healthcare revenue cycle management means navigating multiple challenges. As a result, 54% of healthcare organizations’ Chief Financial Officers (CFOs) choose to outsource the entire process. Nonetheless, a nuanced understanding of these challenges can make things much easier for everyone

Key Challenges Associated With Healthcare Revenue Cycle Management

Challenges associated with revenue cycle management are an integral part of running any successful organization or business entity. However, one can always dodge these challenges provided they have the right understanding and the means to address these complexities. That said, let’s check out some of the most common healthcare revenue cycle management cycles and how healthcare organizations tackle them.

1. Billing Errors 

There is no denying the fact that billing errors are among the most common healthcare revenue cycle management challenges. Even the smallest margins can result in a claim denial, further requiring more resources to address the issue. This hampers the healthcare organization’s potential to facilitate the effective use of available resources and further hampers its healthcare revenue cycle management.

Unfortunately, this is a common issue among healthcare providers of varied scales and based in varied locations around the globe. But in recent years, technology solutions have sprung up as an excellent solution to address these issues for the good. Most healthcare providers are now limiting their reliance on manual input and shifting towards automated billing solutions. This comes as an excellent development since there is no risk of encountering human errors with these solutions.

But using automated billing solutions also offers other perks, including efficient and scalable billing. This allows healthcare providers to use their available human resources for other value-driven tasks. Therefore, it is fair to conclude that automated billing solutions are ideal for organizations dealing with billing errors and helping them ensure better healthcare revenue cycle management.

2. Meeting The Right Compliance Standards 

Another significant healthcare revenue cycle management challenge is ensuring you meet all the right compliance standards. This is a non-negotiable requirement for every healthcare organization considering human life is at stake. But unfortunately, this becomes very challenging for healthcare organizations and further deters them from ensuring healthcare revenue cycle management.

Furthermore, all your patient’s information must remain confidential to meet the right compliance standards. This makes ensuring your healthcare revenue cycle management process works without friction even more important. Failing to do so can result in healthcare providers having to pay penalties and take a dent in their reputation.

Therefore, ensuring regular compliance audits is the best and most effective way to tackle this issue. Besides that, electronic filing of medical claims can be another excellent way to meet all compliance standards without hampering your healthcare revenue cycle management. This is where integrating human ingenuity with technology can translate to great outcomes for every stakeholder in question

3. Poor Collections Recovery Rates 

The human body is one of nature’s most complex creations and can often confuse even the most educated individuals. Hence when a patient seeks medical treatment, there is no way one can determine the exact cause or extent of needed medical treatments. Often, people might seek a diagnosis for a mild issue but later realize something is worse.

As a result, patients’ medical bills keep increasing and fuel more confusion among patients. But more importantly, higher bills also mean an increase in bad debts and a direct negative impact on healthcare revenue cycle management. This makes it very important that healthcare providers find better ways to minimize bad debts.

One easy way to tackle this issue is using a patient-centric payment system or strategy to help patients understand overall billing breakdowns. This also makes it easier for patients to make insurance claims with a nuanced understanding of the coverage. Therefore, the risk of incurring bad debts becomes much less, facilitating better healthcare revenue cycle management.

4. Well-Trained Staff Members 

Human resources are the backbone of almost any organization and even more in the case of healthcare organizations. As a result, it is very important to ensure your healthcare workers have the right training to do their jobs effectively. Failing to do so will have a direct adverse impact on the overall healthcare revenue cycle management of the organization.

Unsurprisingly, there is nothing much you can do about this issue except to train your human resources effectively. Every healthcare organization must focus its efforts and resources on providing clinical and non-clinical training. This will help you boost employee retention, boost staff morale, enhance job competency, and offer more value to patients. But more importantly, this will help you facilitate far better healthcare revenue cycle management.


Revenue cycle management is one probably of the most important components that builds and sustains a successful healthcare organization. Therefore, it is of the utmost importance healthcare organizations take cognizance of its associated challenges and take measures to address them.

So make sure you are mindful of the aforementioned healthcare revenue cycle management challenges and use the solutions to your advantage. This will help you drive better profitability with effective healthcare revenue cycle management.