Top Five Hospital Revenue Cycle Management Challenges

Top Five Hospital Revenue Cycle Management Challenges

The unexpected new era of Covid-19, also bought with it a new set of challenges for the healthcare sector. The industry suddenly found itself in the middle of a colossal crisis, which promises to have profound implications on its future. Challenges such as the search for PPE, instantly deploying nurses, and setting up secure wings became ordeals that required urgent tackling from healthcare executives.

However, it wasn’t just the front-line that faced the brunt of this pandemic’s unsavory consequences. The effects were in fact pervasive, as core operational areas such as business intelligence and hospital revenue cycle management, also found themselves gravely afflicted. 

We now stand at an interesting juncture in time where hospitals are faced with imperative questions on long-held assumptions. There is now a revitalized discussion on making data-driven health systems a tangible reality, and more fervor on doing away with administrative waste for efficient revenue cycle management.

In this article, we will be looking at a few of these challenges facing RCM today, and find out how they can be tackled as the healthcare industry drudges its way through a pandemic.

How Outsourcing Can Help Tackle Hospital Revenue Cycle Management Challenges 

Challenge 1 – Billing Mistakes

There is simply no excuse for mistakes occurring in the billing process as this can amount to millions of dollars in losses. Healthcare executives need to ensure that they consistently collect what they bill for without having to put unnecessary pressure on the patient, which could potentially steer them away from seeking care at your hospital. 

How Outsourcing Helps

Outsourcing gives you access to a competent team of medical billers and coders who possess the experience required to execute the billing process without any errors. 

Challenge 2 – Claims Tracking

A major issue plaguing hospitals today is the issue of claims tracking. These claims have to be persistently monitored to quickly identify errors, and correct them without wasting any time. If these errors are not addressed immediately, then the healthcare organization will start losing revenue.

How Outsourcing Helps

The medical billing company you hire to take care of your revenue cycle is usually well equipped with the right staff and technology needed to track claims. As such, they are proficient enough to identify errors as they occur and resolve them before it is too late.

Challenge 3 – Lack of Adequate Technology

Efficient revenue cycle management requires advanced information technology that can keep track of claims in real-time. Consistent tracking of claims throughout their lifecycle helps healthcare executives ensure denied claims are addressed while payments are collected on time. Most hospitals simply do not possess the infrastructure needed to implement such technology that would have otherwise helped them with efficient revenue cycle management. 

How Outsourcing Helps

As medical billing companies exclusively specialize in rendering billing and coding services, they possess the technology and robust RCM systems needed to keep track of claims. This eventually helps with consistent collections and handling claim rejections efficiently.

Challenge 4 – Employee Training

Hospitals often suffer greatly because staff are not regularly trained on changing regulations. To tackle this, hospitals must invest significantly in education programs and comprehensive training sessions that include lessons on financial policies, coding techniques, and chart documentation for efficient revenue cycle management. However, even if this is addressed, there is still an issue of attrition and the costs associated with hiring new staff to replace the ones who have left the organization. 

How Outsourcing Helps

All of the above-mentioned costs pertaining to employee training and attrition can be saved if the hospital simply chooses to outsource their revenue cycle functions instead. You don’t have to devise education programs and training sessions as you already have a team of competent and experienced medical coders and billers to manage your hospital’s revenue cycle. Furthermore, if your hospital foresees the need to increase the team due to increasing volume, scaling the team with experienced resources will never be a problem. 

Challenge 5 – Suspension of Billing Activity

If even one member of the back office staff is absent, the billing department can witness a substantial decrease in productivity. This also puts additional pressure on other staff members as they are now tasked with more work than they handle. With billing activities suspended, the back office can witness a serious reduction in their cash flow as well.

How Outsourcing Helps


Medical billing companies are already equipped with sufficient staff of professional billers and coders to ensure billing operations remain active perpetually. Staff absence is a typical issue, and outsourcing can take care of it by ensuring billing activities continue to operate without any interruption whatsoever.

The Bottom Line

In retrospect, the novel coronavirus has echoed a need for a better and much more competent RCM system. There are challenges to overcome, and fortunately, there are solutions to help accomplish this diligently. 

3Gen can be your solution to tackle all of the above challenges hindering your hospital’s revenue cycle management. Our experience, in collaboration with a staff of expert medical billers and coders is all you will ever need to ensure efficient management of your healthcare operations as your hospital navigates through this difficult time. 


Johnny Burrell