Running a profitable medical practice is harder than ever. Insurance requirements are increasingly more complicated, claims denials are on the rise, and patients are responsible for a bigger share of their bills. If your practice isn’t keeping up, cash flow can take a serious hit—and recovering lost revenue requires time and resources most practices can’t afford to lose.
Revenue cycle management (RCM) is critical to a healthcare practice’s financial health. When done right, it ensures that payments—from both insurers and patients—are processed efficiently to keep the business running smoothly. When done poorly, it leads to delayed reimbursements and massive administrative headaches.
This article looks at the biggest challenges practices face in managing their revenue cycles and how The Hechtman Group helps providers get paid faster and spend less time chasing payments.
What is Revenue Cycle Management?
RCM encompasses all the financial processes involved in healthcare and helps ensure that providers are reimbursed for their services in a timely and efficient manner. Effective RCM minimizes claim denials and reduces days in accounts receivable to simplify overall financial management.
Components of RCM include:
- Appointment Scheduling & Registration: Collecting patient information and insurance details to determine service needs.
- Charge Capture: Assigning appropriate billing codes for services.
- Billing: Creating accurate claims for insurers and bills for patients.
- Denial Management: Reviewing and addressing claim denials to prevent future occurrences.
- Collections: Identifying and pursuing unpaid charges.
Each of these steps is crucial for maintaining a healthy cash flow. Inefficiencies or errors at any stage can lead to delayed payments and financial instability.
Common Challenges in Revenue Cycle Management
Even the most well-run medical practices struggle with revenue cycle management and can struggle to keep finances on track without diligent oversight. Here are the biggest obstacles standing in the way of a smoother, more predictable cash flow.
Complex Billing Processes
Medical billing is complicated. Payer requirements constantly change, and every insurance provider has its own rules for coding, claims submission, and reimbursement. If your practice doesn’t have the capacity to stay on top of updates, denials and late payments are inevitable.
One of the biggest pain points is coding accuracy—incorrect or outdated codes are among the most common reasons claims are rejected. Additionally, insurance verification errors often result in uncovered services, leaving practices with unpaid claims and patients with unexpected bills. When these issues go unchecked, practices waste valuable time appealing claims and chasing payments instead of focusing on patient care.
Rising Claim Denials
Recent studies show that 19% of in-network claims in ACA marketplace plans are denied, while 37% of out-of-network claims face the same fate—figures that mirror trends in employer-sponsored insurance. These denials slow down payment, but they also create an overwhelming administrative burden, forcing staff to spend hours investigating errors and resubmitting claims.
Denial management is the most time-consuming RCM task, yet many practices lack the resources to adequately handle it. Outdated manual processes, staffing shortages, and ever-evolving payer policies make it nearly impossible to catch every issue before submission. Without a dedicated strategy to reduce denials, practices are at risk of ongoing revenue loss and increased operational strain.
Collections Delays
Even when claims are processed correctly, getting paid on time isn’t guaranteed. Rising healthcare costs mean patients are responsible for more of their bills, yet many lack knowledge of upfront costs, leaving them responsible for more than they anticipated. When unexpected balances hit, payments are often delayed—or missed entirely. For practices, this means longer collection cycles and more staff time spent trying to collect payments. Setting clear coverage and payment expectations upfront can help reduce delays and keep revenue flowing.
Administrative Overload
Managing RCM is a major drain on resources. Physicians and staff are already stretched thin, yet too much time is spent handling billing, claims, and collections. Many practices simply don’t have the technology or dedicated expertise to run an efficient revenue cycle. As a result, they’re bogged down by manual processes that make it nearly impossible to keep up. Outsourcing medical accounting can help lighten the load, ensuring RCM is well-managed so staff can focus on providing quality patient care.
Achieving Better Revenue Cycle Management with The Hechtman Group
For many healthcare providers, inefficient billing and collections drain resources and disrupt cash flow. But it doesn’t have to be that way. The Hechtman Group offers a suite of accounting services for medical practices—including specialized revenue cycle management consulting to help practices increase profitability by improving billing and collections processes while taking the burden off internal teams.
Ready to take control of your revenue cycle? Contact The Hechtman Group today to learn how expert support can improve cash flow and reduce administrative headaches.