Top Challenges and Solutions of Small Healthcare Companies -blog

Top Challenges and Solutions of Small Healthcare Companies

Say yes to Outsourcing! 

Being a solo practitioner, do you accept the delayed and denied payments? For how long?

Sharing your burden with healthcare BPO will never be a bad move!

We understand your hesitation, but a precautious step will always be paid off with greater profits.

Small healthcare business might seem trouble-free which is actually not true. Unlike the other healthcare professionals, solo physicians will have limited patient responsibilities as they won’t have expandable facilities.

There’s a misconception about the cost and expenditure when outsourced with a healthcare BPO regardless the challenges they come across.

The frequent challenges most of the small healthcare business encounter:

  • EHR Data Entry
  • Quality Measures
  • Less Reimbursement
  • Decreased Patient Communication
  • Data Security
  • Battling Stress
  • Cost and Infrastructure


  1. EHR Data Entry:

  • EHR data entry has been a tough job for a solo physician as it prevents  them from patient responsibility.
  • Only 27% of the healthcare professional’s time is spent on patient care with nearly more than half of the time is spent on EHR and desk work.
  • Interaction with the patients should be the primary work for healthcare provider. When they fail to do it, they would fall into the pit holes of revenue loss.
  • Healthcare BPO can actually indulge in providing the necessary aid that a healthcare provider would require.
  • Outsourcing EHR related tasks to a healthcare BPO can reduce the stress and increase patient responsibility.
  • Healthcare BPO companies are well equipped to provide feeds to EHR system to physician’s need in lesser time.
  1. Quality Measures:

  • The cost category based on claims data becomes 10% of eligibility final MIPS score.
  • It affects the physicians who are already facing issues in delivering required data to demonstrate improvement in care, delivery, value and efficient services, as well as use of EHR to meet quality measures.
  • With the support of an efficient healthcare BPO company, providers can focus on patient care and quality measure, reporting that can ensure far-reaching revenue cycle management.
  1. Less Reimbursement:

  • Healthcare professionals or small healthcare business finds it difficult to keep updating with the ever changing medical codes and rules.
  • The submitted claims to insurance companies will require a screening to check if the claim comes under their policy or details are entered accurately.
  • Any errors spotted in patient demographic details or eligibility verification will be pushed to denials. If not followed up regularly, it leads to revenue loss and reimbursement failure.
  • Intelligent way to avoid such scenarios is to share the in-house billing job with healthcare BPO and receive greater reimbursements without any revenue loss.
  1. Decreases Patient Communication:

  • EHR has impaired communication and patient relationship due to the distraction in EHRs pose at the office visit.
  • When the physician focuses on the Electronic Health Record, there will not be time for patient responsibility. The time categorized for the patient would be very less.
  • So, the healthcare professionals cannot involve themselves in engaging with patients and paying more attention to them.
  • Healthcare BPO encourages the providers to maintain good patient responsibility by submitting accurate EHR to the insurance companies.
  1. Data Security:

  • Privacy issues and data breaches are top most challenges for providers.
  • About 233 data breaches were reported in 2017. They involved thousands of patients whose personal health information was compromised.
  • HIPAA-compliant service provider can ensure compliance with best practices for data security to avoid HIPAA violation.
  1. Battling Stress:

  • Physical and emotional stress is making healthcare providers exhausted.
  • A recent study States that about 50% of physicians are stressed out as they are having tough time coping with the challenges.
  • Financial and administrative challenges are the major concerns. Burnout can affect potentially successful career.
  • Physicians must manage to focus on their priorities and release their burden on to outsourcing company to experience stress less RCM services.
  • Delegating administrative responsibilities and other tasks to a reliable healthcare BPO can make things better.
  1. Cost and Infrastructure:

  • Small healthcare providers can access to limited patient responsibility as they spend more time on in-house billing.
  • Staff training and hiring employees for back office assistance includes lot of work, space and also costly.
  • It’s general that the expenses for paying billers, covering employee benefits and implementing technology systems is not a common task for small healthcare business.
  • Outsourcing medical billing and coding to a highly qualified technologically advanced services or companies is a practical strategy to ensure seamless flow of revenue without any denials.
  • Untrained staff tends to submit errored claims which could often lead to denials and if unnoticed, healthcare professionals should be ready to bare the revenue loss.

Few steps for Small healthcare companies to reduce revenue loss.

  1. Gather Information:

  • Most of the revenue problems and revenue loss occur and start at the initial stage of registration.
  • The staff must be well aware of the patient’s insurance information, pre-authorization and coverage policies.
  • Any error or mistake in the above process will lead to claim denials and if unnoticed, it becomes revenue loss.
  1. Reporting:

  • Don’t hesitate to report if the data entered is incorrect and has resulted in claim denials.
  • Never wait for a month when the rework had begun already.
  1. Confirm the Reimbursement:

  • Before the patient registers, confirm if he/she is eligible for particular service and also make sure if the payments are reimbursed for the services rendered.
  1. Payment Collections from patients:

  • Try everything possible to get paid before or at the time of service as determining all charges is hard.
  • Collect payments as soon as possible for the highest charge that isn’t likely to require a refund. By doing this, you can avoid lot of confusion.
  1. Proper Documentation:

  • Document every detail or the information completely and accurately about the patient diagnosis and services performed to avoid denials and as an evidence for appeal process.
  1. Don’t hire untrained staff:

  • Always look for the billing and coding experts with years of experience in the healthcare industry.
  • They should be able to do error-free job to present denials and rejections. High turnover aiming patient access personnel can have major impact on medical billing process.

Business can be small or big, but the effort is the same. To avoid stressful billing and relax on your chair treating patients, outsourcing is the best choice.

Hope you all got the necessary information through this article. If you want to know more or suggest more, please comment below. For more queries and updates on healthcare, please subscribe to our blog.

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