Challenges in Medical Billing Industry

With constant innovation in medical diagnostic procedures, treatment processes, administration, and a rapidly increasing volume of patients, the healthcare sector is easily one of the fastest revenue generating sectors today. Medical billing services are an integral part of the cycle. It is projected that healthcare BPO market would be worth around 17 billion dollars by 2024.

In the past few years, the field of medical billing has undergone significant changes. The new presidency and government machinery had always been expected to make crucial changes in the healthcare sector ever since Donald Trump assumed the presidency. Healthcare has always been in a constant flux of volatility with recent reform changes in insurance and medical billing processes.

Here are some of the challenges that the medical billing sector is likely to face going forward.

  • High Claim Rejection – According to a research conducted by the California Nurse Association, an alarming 22% of the claims that were submitted were rejected. Furthermore, around 40% of the claims rejected were never put forward for re-submission. The factors behind these alarming rates of rejection vary from lost claims, missed deadlines, to a generally cavalier attitude to working the process. In cases where a claim doesn’t translate to payment, it’s either because a claim was not received or there was a defective claim as a result of wrong data or the absence of proof for the billed services.
  • Failure to Re-Appeal – In most case scenarios, the hospital administration pays due diligence in submitting the claim; however, nonpayment can occur as a consequence of a clerical or administrative error. When this happens, it’s basically not viable economically for the administration to pursue the claim further with follow up until payment is made.
  • Incorrect Claims – The American Medical Association has stated that around 10% claims are not paid properly with commercial mainstream payers underpaying on close to 10% of their claims.
  • Bloated non-core Medical Costs– Another serious challenge facing the billing industry is the revenue distribution allocated towards administrative processes in the healthcare sector which includes Medical Billing, claims processing, Of the nearly 3 trillion dollars spent on healthcare, a large chunk of around 400 billion dollars goes to administration charges. This has been attributed largely to outdated technology being used to implement transactions between the payer and the provider.
  • Physician Burnout – In many scenarios, the practitioners are burdened with a great deal of administrative responsibilities, which includes entering EMR data for medical billing purposes. This takes up a lot of time and energy that should actually be spent with the patient and the core medical process. This eventually leads to fatigue and errors, which again translates to a major challenge for medical billing.
  • This is why outsourcing administrative processes such as medical billing to a third party that is skilled and efficient at the job is a welcome solution to making the healthcare sector streamlined and cost-effective.

Related Posts


  1. I must express my appreciation to this writer for rescuing me from such a dilemma. Right after checking throughout the internet and getting methods which are not powerful, I thought my life was done. Existing devoid of the solutions to the problems you’ve solved as a result of your review is a critical case, and the kind that might have badly affected my career if I hadn’t noticed your web page. That training and kindness in controlling everything was crucial. I am not sure what I would’ve done if I hadn’t come across such a point like this. I can at this time look ahead to my future. Thanks very much for the reliable and effective help. I will not be reluctant to endorse your web sites to anybody who wants and needs guide on this problem.

  2. My spouse and I stumbled over here coming from a different web page and thought I should check things out. I like what I see so i am just following you. Look forward to exploring your web page for a second time.

  3. My spouse and i ended up being very peaceful when Edward managed to carry out his homework with the ideas he came across through your web site. It’s not at all simplistic to simply happen to be handing out helpful hints that many others could have been making money from. And now we recognize we now have you to give thanks to because of that. These illustrations you made, the simple website navigation, the friendships you will aid to foster – it’s everything awesome, and it’s really making our son in addition to the family believe that this issue is satisfying, and that’s unbelievably essential. Many thanks for all the pieces!

  4. I抦 impressed, I need to say. Actually not often do I encounter a weblog that抯 both educative and entertaining, and let me let you know, you have hit the nail on the head. Your idea is outstanding; the issue is one thing that not enough individuals are speaking intelligently about. I am very blissful that I stumbled across this in my search for something regarding this.

  5. I am glad for writing to make you understand what a extraordinary discovery our child found going through your site. She came to understand plenty of issues, including what it’s like to possess a marvelous teaching heart to let the rest completely learn about a variety of tortuous issues. You undoubtedly exceeded our own desires. Thanks for delivering these warm and friendly, dependable, edifying and cool guidance on this topic to Kate.

  6. I wish to express my appreciation to you for rescuing me from this type of challenge. Just after exploring through the search engines and meeting advice that were not productive, I assumed my entire life was done. Living without the approaches to the issues you’ve resolved all through your entire report is a crucial case, as well as ones that would have adversely affected my career if I hadn’t discovered your website. Your main skills and kindness in playing with a lot of stuff was very helpful. I don’t know what I would have done if I had not encountered such a solution like this. I can also at this time look ahead to my future. Thanks very much for the skilled and sensible guide. I will not think twice to refer the sites to anyone who requires tips about this subject.

  7. I enjoy you because of all your effort on this web page. Kim really likes participating in internet research and it’s easy to see why. I hear all of the lively ways you deliver functional techniques through the website and as well as improve response from other individuals on this theme then our princess is always starting to learn a lot. Have fun with the rest of the new year. You are performing a wonderful job.

  8. I have to voice my passion for your generosity in support of men and women who should have help on in this concept. Your real dedication to getting the message all around became rather significant and has really allowed many people just like me to arrive at their targets. Your personal warm and friendly guideline denotes this much a person like me and even more to my peers. Thank you; from all of us.

  9. A lot of thanks for each of your effort on this web site. Kate takes pleasure in going through internet research and it’s easy to see why. I hear all relating to the dynamic manner you render priceless suggestions by means of this website and therefore foster response from some other people on the matter while our favorite princess is really understanding a great deal. Take pleasure in the remaining portion of the new year. Your doing a good job.

  10. Once I originally commented I clicked the -Notify me when new comments are added- checkbox and now every time a comment is added I get four emails with the same comment. Is there any approach you’ll be able to remove me from that service? Thanks!

  11. Thank you a lot for giving everyone remarkably terrific chance to read critical reviews from this website. It’s always very awesome and also jam-packed with amusement for me and my office friends to search your site really three times in a week to see the latest guides you will have. Of course, I am just actually fulfilled with your splendid thoughts served by you. Some 2 tips in this posting are essentially the most effective we have all ever had.

  12. I抦 impressed, I need to say. Actually hardly ever do I encounter a weblog that抯 both educative and entertaining, and let me tell you, you might have hit the nail on the head. Your idea is excellent; the difficulty is one thing that not sufficient people are talking intelligently about. I am very happy that I stumbled throughout this in my seek for something regarding this.

  13. A lot of thanks for your whole hard work on this blog. My mom enjoys working on investigation and it is easy to understand why. Almost all hear all concerning the lively tactic you deliver good tactics on the web site and recommend participation from the others on that subject while our favorite daughter is truly understanding a lot. Take pleasure in the rest of the year. You’re conducting a good job.

  14. Thank you a lot for giving everyone such a terrific chance to check tips from here. It really is so beneficial and as well , packed with amusement for me personally and my office peers to search your website at least 3 times per week to study the latest secrets you have. And lastly, we’re at all times impressed with all the stunning creative ideas served by you. Certain 3 tips in this article are undoubtedly the finest we have ever had.

  15. Thanks so much for giving everyone an exceptionally pleasant chance to read critical reviews from this website. It is usually very pleasant plus full of a lot of fun for me personally and my office acquaintances to search the blog the equivalent of three times in 7 days to find out the fresh guidance you have. And indeed, we’re usually happy with the effective things served by you. Some 3 areas in this posting are unequivocally the most efficient I’ve had.

  16. I wanted to write you the bit of observation in order to thank you as before considering the exceptional techniques you’ve featured in this case. It is quite shockingly open-handed of you to convey publicly exactly what a few individuals would have marketed for an e book to help make some bucks on their own, certainly since you could have tried it in case you decided. These pointers additionally worked to provide a good way to comprehend someone else have similar interest similar to my personal own to know the truth significantly more with respect to this matter. I’m sure there are a lot more pleasurable opportunities up front for those who looked over your blog.

  17. I am writing to make you know of the perfect encounter my friend’s daughter found reading through your webblog. She figured out some things, not to mention what it’s like to have a marvelous coaching style to let most people effortlessly thoroughly grasp several specialized subject areas. You undoubtedly did more than people’s expectations. Thanks for providing the warm and friendly, trustworthy, explanatory and in addition cool guidance on this topic to Ethel.

  18. I definitely wanted to write a small message so as to appreciate you for the unique steps you are sharing on this site. My incredibly long internet look up has at the end of the day been compensated with reliable insight to share with my family members. I ‘d tell you that most of us readers are unquestionably fortunate to be in a very good network with so many brilliant individuals with interesting principles. I feel quite happy to have seen your webpages and look forward to so many more pleasurable minutes reading here. Thank you once more for all the details.

  19. I wanted to write down a word to be able to express gratitude to you for the lovely strategies you are writing here. My considerable internet investigation has now been recognized with awesome ideas to talk about with my companions. I ‘d point out that most of us readers actually are extremely endowed to dwell in a fine site with many outstanding people with very helpful tactics. I feel quite lucky to have discovered your entire site and look forward to really more enjoyable times reading here. Thanks a lot once more for all the details.

  20. I happen to be writing to let you understand of the wonderful encounter my wife’s girl enjoyed using your site. She discovered such a lot of details, with the inclusion of how it is like to possess an excellent teaching heart to make the rest really easily know precisely selected multifaceted subject areas. You truly did more than readers’ desires. Thank you for coming up with such good, dependable, informative not to mention cool tips on this topic to Mary.

  21. After research a couple of of the blog posts in your website now, and I really like your method of blogging. I bookmarked it to my bookmark website list and can be checking again soon. Pls take a look at my website online as nicely and let me know what you think.

  22. I enjoy you because of your own work on this web page. My mother enjoys participating in research and it’s really easy to see why. Most people learn all regarding the dynamic tactic you give simple tips through this website and even increase participation from some others on this situation while our own child is always being taught a lot of things. Take advantage of the remaining portion of the new year. Your conducting a brilliant job.

  23. I really wanted to develop a comment in order to appreciate you for all the remarkable pointers you are giving out on this website. My rather long internet lookup has at the end been rewarded with beneficial information to write about with my friends and family. I ‘d say that most of us visitors actually are extremely endowed to dwell in a very good network with so many perfect professionals with good concepts. I feel extremely privileged to have come across your entire weblog and look forward to some more entertaining times reading here. Thank you again for a lot of things.

  24. I as well as my guys were actually reading the excellent points found on your website while before long came up with an awful feeling I never expressed respect to the site owner for those secrets. Most of the young boys appeared to be consequently glad to read them and have now without a doubt been making the most of those things. Thanks for actually being indeed considerate as well as for pick out this form of really good useful guides most people are really eager to understand about. My personal sincere apologies for not saying thanks to earlier.

  25. My spouse and i got quite thrilled Emmanuel could do his studies through the precious recommendations he obtained from your very own site. It is now and again perplexing just to choose to be giving out tips that many many people might have been selling. And we also recognize we have got you to give thanks to because of that. The most important illustrations you have made, the simple site navigation, the friendships you help create – it is all unbelievable, and it is assisting our son in addition to the family know that that issue is awesome, which is certainly rather pressing. Many thanks for everything!

  26. I together with my friends have been studying the good suggestions located on your web page then suddenly I got an awful feeling I never expressed respect to the web blog owner for them. All the young men were definitely certainly stimulated to learn them and now have clearly been enjoying them. Thanks for indeed being really accommodating and for opting for these kinds of fantastic subjects millions of individuals are really desirous to be informed on. My very own honest regret for not expressing gratitude to you earlier.

  27. Thanks so much for giving everyone an exceptionally pleasant possiblity to check tips from this site. It is always so lovely and as well , full of a great time for me and my office acquaintances to visit the blog at minimum 3 times in one week to find out the new secrets you have got. And definitely, we are usually pleased with the stunning inspiring ideas served by you. Selected two ideas in this posting are rather the simplest I’ve ever had.

  28. I wanted to send you that tiny remark to finally say thanks a lot the moment again for those pleasing methods you have shared on this site. It is unbelievably open-handed with you giving unhampered precisely what a lot of folks could possibly have offered as an electronic book to help with making some bucks for their own end, especially given that you could possibly have done it in the event you desired. These advice likewise acted to provide a good way to be sure that someone else have the identical dream like my very own to learn way more when it comes to this problem. Certainly there are millions of more fun periods in the future for many who discover your blog.

Leave a Reply

Your email address will not be published. Required fields are marked *