Top Challenges in processing Medical Billing

Like any other professional, medical professionals also face various challenges in managing different sectors of a healthcare facility like medical billing. Whether it is a question of medical claims, software used for the revenue cycle, or patient cooperation, they face something or the other every time. Below we have shared some of the most common challenges that healthcare facilities face in Medical Billing Management.

  • Information to the patients

You have to keep your patients informed and educated when it is a question of billing. Otherwise, the healthcare providers might face difficulties. As per the research, when a patient is aware of their billing amount, payment methods, balance, and other options, they will clear all their outstanding rapidly. A third-party company with high-standard billing management software and EHR can assist you in clearing all the bills hassle-free and with efficiency. Also, many medical practices continue to provide Medical Billing Solution manually, which lead to the absence of transparency and human errors. There will be a high chance of claim denial if the billing information is incomplete or incorrect. 

  • Accessibility to payment

Mostly, healthcare facilities do not receive payments on time which leads to a decrease in revenue. This situation can arise due to a lack of efficiency of the software or time. You also have to ensure you offer multiple payment options to them, like credit and debit cards and online payments. Enhancing payment accessibility is always the best option. 

  • Filing for more than one claim

If you have to file for more than one claim, it can be sometimes frustrating, especially for the healthcare service providers. For instance, Nephrologists have to conduct numerous cases of dialysis claims every day. Without any help from an outsourcing billing management company or mass cremation tool, they have to file each claim manually and individually. It can have an enormous impact on the clinical workflow and practice efficiency.

  • Resources

Lack of proper medical billing resources will leave you no option other than to do all the aspects of Medical Billing in Avondale like patient billing, management of quality software, customer support, or productivity tools all by themselves. Proper billing resources are highly necessary for maximizing the revenue and submitting the highest clean claim numbers. 

  • Implementation

You will be in immense trouble if your medical billing company does not offer assistance or any coding-related error in your software. Correct support during medical billing implementation is highly essential for the success of your medical practice.

  • On-time payments.

Sometimes it becomes difficult to receive the necessary payment within the required time frame, be it from a patient directly or the insurance company. But if you outsource your medical billing processes to a third party, they will assist you in receiving all the pending claims and payment from the patients within time.

  • High standard customer support

An outsourced medical billing company will offer solutions relevant to any operation difficulties or problems in understanding the payment options. They also provide high-quality customer support to the patients related to billing queries. 

  • Denials

After processing the claim, sometimes the payer refuses to pay, known as the claim denial. There are a total of five denial types, which are soft, avoidable, administrative, harsh, and clinical. Most of the claims are avoidable and need to get resubmitted after the problem gets removed. There is nothing more frustrating than the healthcare providers if they receive a denial in the payment after treating the patient successfully. With various changing medical codes all across the globe, it is getting quite tough to stay on the right track of acquiring the medical bills and achieving all your profit goals. With the correct tools, healthcare facilities can enhance their claim percentage above 99 and protect their industry adjustments. 

  • Software

If the software necessary for Medical Billing Solution is uncustomized as per your requirements, it will interrupt the billing workflow. Never go for all-in-one software as it might not fulfill your billing demands.

  • Loss of revenue

Loss of revenue can be due to multiple factors. But if the loss is primarily due to mistakes and errors in the Medical Billing Management, it is frustrating. To avoid these losses, you will require the appropriate tools to achieve the financial goals and lower the lost revenue. 

  • Ineligibility of the patient

Ineligibility to pay by the patient is one of the biggest challenges the medical professional faces during the billing process. It indicates that the insurance does not cover the payment submitted by the patient. Thus, it is necessary to verify the coverage and health insurance status of the patient before processing the treatment. But it becomes difficult for the front office staff to do these add verification after doing all the billing processing. 

  • Absence of automation and technology

A billing system with manual processing requires extensive time for the claim. Customized decision support and claim reporting in advance are not available to those healthcare facilities that have not automated their medical billing system. Also, updated technology implementation will help you to prioritize, channel, and manage the claims correctly. Even if you are the best person to handle medical billing, the absence of appropriate technology will make the process of handling claims difficult and inefficient. 

A solution to tackle these challenges 

The only solution you can do as a medical professional to face all the above challenges is to outsource the services of a high-quality medical billing processing company. Appointing the top company will make all the difference. Some of the most notable characteristics of the best third-party billing company include pioneer customer support, customized billing reporting and tools, up to 99% of claims, updating the coding of the software, and more. 


So these are the top challenges that medical facilities face while maintaining their Medical Billing in Avondale. However, you can easily avoid these difficulties by hiring a reputed medical billing management company like PMBC to handle the claims, collections, and other maintenance through coding the software. By handling all the payment and claim-related difficulties by them, you can concentrate fully on treating your valuable patients. 


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