Medical billing is a process used by healthcare, NEMT, and homecare providers to gather, create, and submit information to payers to receive reimbursement for services provided to patients. The processing of preparing a bill from start to finish can be a lengthy, complex one, but with the help of medical billing software, providers can bill faster and reduce the amount of rejected and denied claims. A long, in-depth process like this comes with its own set of challenges for providers to navigate. While these challenges may slow the process and frustrate billers, they’re usually just a minor inconvenience when it comes down to it. What are some of these challenges, and what do they mean for billers?

Challenges with medical billing

No process is perfect, and medical billing comes with a variety of challenges every day. Setbacks are always frustrating, but understanding what they mean and how to manage them will make your job easier and get you back on track in no time. Below we’ve outlined a handful of the most common medical billing challenges:


Claims are denied when insurance companies deem them unpayable. This could be due to a number of reasons including incorrect information, missing information, or lack of insurance coverage. Most denied claims are preventable with better attention to detail and a greater collection of information up front. If you receive a denied claim, it’s usually possible to fix the mistake and re-submit for processing. 

Accurate information

It’s nearly impossible to avoid a mistake here and there, but when they become regular, it’s time to change the process. Mistakes are most often made when information is taken and sorted manually. The best way to ensure accuracy is by using medical billing software at your practice. 

Patient eligibility

One of the biggest causes of denied claims is patient ineligibility, meaning the patient’s insurance doesn’t cover the service they received. The best way to prevent this mistake is by having front-end staff verify this information up front. 

Manual billing

If you’re still billing manually, you’re creating a slower, less efficient process for yourself. Manual billing doesn’t come with error checks or automated data entry, so human error is likely to occur from time to time. Investing in software that submits error-free claims is well worth it in the long run. 

The future of medical billing

As life moves forward, technology continues to evolve to cater to our ever changing needs. Medical billing is no exception. Those in the industry have already noticed trends that are sure to emerge within the coming years, making medical billing a simpler, more effective process for everyone involved. These are just two examples of technologies that will change the way medical billing is done:

Computer-assisted coding (CAC)

Computer-assisted coding is meant to speed up coding time while reducing claim backlogs. Coding can be a difficult, long process, but CAC identifies gaps in documentation, so coders know where information is still needed and can work quicker overall. 


Introducing blockchain data storage into your process can offer enhanced privacy protection, better information exchange and increased control of your data. Blockchain is a chance to enhance your overall operation for increased productivity, accurate reimbursement and better reporting tools. 

Take medical billing further

Medical billing is crucial to the healthcare industry. It’s the process that allows businesses to get reimbursed properly and, ideally, in a timely manner. Medical billing is important and should be treated as such. So if you’re still filing claims manually, it’s time to look into software options. Billing software helps you submit error-free claims and receive reimbursements even faster than before. It also gives you access to customized reporting that will help improve your operation. If you’re ready to explore billing software options, including NEMT billing software, Medicaid billing software, and more, get in touch with the team at iSi Technology for more information!