5 Revenue Cycle Management Challenges to Overcome

November 14, 2022

At every point of the patient journey, from patient access to claims, billing, payment, and collections, there are issues with the healthcare revenue cycle. But with the integration of digital technologies and analytics, these tools can support providers in overcoming their most pressing revenue cycle issues in healthcare. If problems with revenue cycle management (RCM) are not resolved, there could be a revenue loss. Providers can easily manage complexity and adjust to changing patient demands with the aid of the latest technologies, such as data and analytics, digital tools, and automation.

Top 5 Revenue Cycle Management (RCM) Challenges

Below are the top 5 revenue cycle management (RCM) challenges healthcare practices are facing:

Issues with Patient Access

When choosing a provider, booking appointments, and managing pre-appointment tasks like registration and insurance verification, customers are accustomed to using mobile apps and online services to enjoy a seamless digital experience.

Patient access, such as patient portals with a digital focus, assist providers in enhancing the patient journey and registration accuracy, in addition to providing precise estimations and practical payment alternatives. Manual procedures need more initial staff time; mistakes made by humans can result in claim denials or incorrect billing later in the cycle. The process is streamlined through automation. With the help of patient intake software that can be used both mobile or online, healthcare practices can efficiently deliver flexible and top-notch digital experiences.

A Poor Ratio of Collections Recovery

Patients are having a more challenging time making ends meet due to high deductible health plans that require them to pay a more significant portion of the expense of their medical care. Higher costs mean more uncertainty, concerns about insurance coverage, and a higher need for financing solutions. As greater attention is placed on the patient as a payer, providers require effective collection tactics to increase revenue.

Patients can better understand their expected expenses, insurance coverage, and payment alternatives with the assistance of a patient-centered payment strategy. Medical organizations need to support patients with the following in order to assist them in effectively navigating the financial process and difficulty with the healthcare revenue cycle:

  • The providers need to give patients a precise and accurate estimate so that they will have a clear understanding of the payment they need to pay up-front.
  • Flexible and secure payment methods need to be provided so there will be no issues.
  • Payment plans need to be navigated.
  • Try to integrate a solution that encourages payment before service.  

With the help of digital tools, providers can easily optimize collections processes by prioritizing the accounts as per balance, automating billing processes, and taking other practical steps to increase profitability.

Errors in the Billing Process

Missing payments or underpayments are one of the critical factors of stress and volatility in a revenue cycle. Billing errors and A/R days can be decreased by replacing manual operations with digital technologies to streamline workflows. Before claims are submitted, integrated claims management software checks them for inaccuracies in coding, minimizing claims denials and lowering the time between billing and payment. Integrating the right RCM solution will get the desired results. TalkEHR’s revenue cycle management solution is designed to help practices collect every dollar. With the help of an experienced team, practices can reduce running costs and increase profitability.

Changes in Healthcare Regulations

The healthcare industry constantly faces new rules. But maintaining a healthy revenue cycle in healthcare is one of the most significant issues that providers face. Claim denials, payment delays, and administrative and invoicing backlogs will be the result if practices fail to keep up with the changing regulations in the healthcare industry.

The Role of Data Analytics

For providers who are looking to identify and address problem areas, getting help from data and analytics is essential. With the use of talkEHR’s financial analysis tool, practices can make data-driven decisions. These decisions will be a critical factor in improving the practice’s profitability. With the help of year-to-year comparison reports, providers will have an idea about the areas that need to be improved or are not showing results up to the mark. Secondly, with the integration of these top-notch tools such as RCM and analytics, healthcare organizations can simplify decision-making. Visual interfaces help professionals to analyze data quickly and customize reports as per need.


In this article, we have thoroughly explained the challenges with the revenue cycle and how to overcome them; we have discussed all the key factors, such as the role of analytics in improving decision-making, continuous changes in the healthcare compliance landscape, and how to overcome it, errors in the billing process and how integrating a top-quality solution will help collect every dollar and issues with the patient access software. Moreover, we have also shed light on talkEHR’s financial analytics solution to help the practice meet its revenue goals.