How Medical Practices Can Overcome Top RCM Obstacles

July 11, 2025

If you're managing a large independent medical practice, you know that revenue cycle management (RCM) isn't just a back-office function—it's the lifeblood of your organization. Between evolving payer policies, staffing hurdles, and technological complexities, maintaining a strong financial standing is more challenging than ever.

Here's the good news: with the right strategies and tools, you can navigate these obstacles effectively. Let’s break down some of the top RCM challenges today and how you can overcome them.

The Prior Authorization Predicament

Prior authorizations continue to be one of the most frustrating obstacles in healthcare revenue cycles. Providers report that the administrative burden not only eats up staff time but also delays patient care, sometimes significantly. In fact, 97% of providers say prior authorizations lead to treatment delays, and more than 80% say the burden has gotten worse over time.

The problem is even more complex for independent practices managing multiple specialties or payer contracts. Each insurance company has its own evolving rules, and without automation or standardization, it’s nearly impossible to stay ahead.

To address this, practices should implement technology that automates prior authorization submissions and follow-ups. Monitoring denial reports can help identify recurring issues tied to authorization delays. It’s also a smart move to standardize workflows, so your team isn’t reinventing the wheel every time a request comes in.

Staffing Shortages and Burnout

The nationwide healthcare staffing shortage hasn’t spared the revenue cycle side of the business. Skilled medical billers, coders, and front-office personnel are in high demand, and independent practices often can’t compete with hospitals or health systems when it comes to salary or benefits.

What’s more, the constant pressure to do more with less has taken its toll on staff morale. Many billing teams are being asked to process more claims, chase more payments, and troubleshoot more denials without additional support. Burnout leads to errors, turnover, and ultimately, a negative impact on collectible revenue.

Using automation to handle repetitive tasks like charge entry and follow-ups can free up staff to focus on higher-value work. Waterfall or cash flow reports can identify where your staff's focus needs to be spent to optimize their time and collect the most possible revenue. Additionally, don't underestimate the power of investing in professional development—it’s a great way to retain your existing team and help them grow.

Rising Patient Financial Responsibility

Patients are paying more out-of-pocket for healthcare than ever before. High-deductible health plans, increasing copays, and shifting payer strategies mean that more of your revenue depends on individual patients paying their bills. Medicare deductibles and cost-sharing are on the rise in 2025, which means practices can expect an even higher volume of time spent collecting patient revenue.

This shift creates a new layer of complexity for the revenue cycle. Practices must now act more like retail businesses, with a focus on clear pricing, upfront estimates, and patient-friendly billing. Unfortunately, many independent practices are still using outdated processes that don’t support that level of transparency and convenience.

Being transparent about pricing from the start helps patients plan and prevents surprise billing issues. Offering flexible payment plans and online options can make it easier for patients to settle their balances. Practices should also analyze patient financial data to segment outreach efforts and tailor communication strategies accordingly.

Data Silos and Integration Gaps

Many independent practices are still using disconnected systems for scheduling, billing, clinical documentation, and patient communication. When those systems don’t talk to each other—or don’t talk well—revenue cycle performance suffers.

Billing teams waste valuable time switching between platforms, reconciling data manually, or chasing missing information. Worse, fragmented systems make it harder to spot performance trends or fix problems proactively. Only 55% of hospitals report that they can effectively share patient information with external providers, and independent practices fare even worse.

It’s essential to invest in integrated solutions that eliminate data silos and reduce redundancies. Choose vendors that deliver true interoperability—not just marketing buzzwords—with proven track records of successful system communication. 

Cybersecurity Threats

Cyberattacks on healthcare organizations are increasing in both frequency and severity. In 2024 alone, over 167 million healthcare records were exposed in data breaches, double the previous year’s total.

For independent practices, a single cybersecurity incident can be devastating. Beyond the financial penalties and recovery costs, breaches erode patient trust and can trigger lasting reputational damage. Unfortunately, smaller practices are often seen as easier targets, especially if they lack dedicated IT staff or robust defenses.

Practices must upgrade their cybersecurity defenses with tools like encryption, multi-factor authentication, and regular vulnerability testing. Seek out software with cybersecurity certifications such as HITRUST’s e1. Staff training is just as important since human error remains a top cause of security breaches. Finally, every practice should have a well-documented incident response plan to act quickly and minimize damage if a breach does occur.

Regulatory Changes Keep Coming

Whether it's the ongoing rollout of the No Surprises Act, changes in procedure codes, or payer-specific billing requirements, the only constant in healthcare regulation is change. Independent practices don’t always have compliance departments on standby, which means staying current often falls to already-overextended practice managers or billing leads.

Missing even a small regulatory update can lead to denied claims, recoupments, or fines—none of which you want on your plate.

Assigning a dedicated compliance lead can ensure someone is always keeping tabs on regulatory updates. Documenting workflows and policies can help keep your practice audit-ready at all times. Additionally, to ensure that your staff stays informed and aligned as new rules roll out, consider hosting quarterly training sessions.

Final Thoughts

Managing an independent practice’s revenue cycle today is no small feat, but it’s absolutely doable with the right tools. By embracing RCM best practices, automating where possible, and keeping your data connected, you’ll spend less time putting out fires—and more time building a financially healthy, patient-focused practice.

Need help optimizing your RCM?
OpenPM helps independent practices tackle everything from denials to data silos. Let’s talk about how we can support your team in overcoming RCM challenges and getting paid faster.