Healthcare Executives Highlight Ongoing Critical Gaps in Patient Identity Management, Eligibility Verification, Charge Capture Accuracy and Denial Processing, Underscoring the Urgent Need for Comprehensive Interoperability Solutions
DENVER, COLORADO / ACCESS Newswire / June 27, 2025 / Black Book Research today released detailed findings from its 2025 annual revenue cycle management (RCM) study, highlighting significant interoperability and data integration challenges confronting healthcare provider organizations. This targeted analysis is based on responses collected between July 2024 and May 2025 from 540 senior leaders responsible for RCM, IT, finance, and patient access at hospitals and health systems nationwide.
The comprehensive annual RCM study incorporates feedback from verified users of revenue cycle systems, representing one of the largest independent surveys in the healthcare industry. This year's specific interoperability and data integration assessment revealed persistent challenges in effectively managing data handoffs between electronic health records (EHRs), patient accounting platforms, patient access tools, and collections systems. Participants attributed these challenges primarily to disjointed technology infrastructures and siloed departmental workflows, issues that significantly disrupt operational efficiency and revenue integrity.
"Despite substantial investments in digital solutions, many healthcare systems continue to struggle with fragmented patient identity management, incomplete real-time data integration, and departmental isolation," said Doug Brown, founder of Black Book Research. "These interoperability issues have evolved beyond technical obstacles into strategic financial risks directly impacting revenue cycle performance."
Top Interoperability Challenges Identified by RCM Leaders
Based on analysis of the 540 respondent subset focused on interoperability issues, the following four categories emerged as the most critical to address in 2025:
Patient Identity and Demographic Inconsistencies Cause: Fragmented patient identity data across clinical and financial platforms. Impact: Duplicate records, claim rejections, and downstream billing errors. (74% of respondents reported experiencing significant issues with duplicate records and patient identification errors before adopting targeted solutions.) Top-rated vendor addressing this 2025 interoperability challenge: Verato.
Eligibility and Authorization Discontinuities Cause: Lack of real-time integration of insurance eligibility and prior authorization data into scheduling and billing systems. Impact: Delayed reimbursements, retrospective authorizations, and increased denials. (81% of respondents reported challenges with delayed reimbursements and prior authorization delays prior to implementing integrated solutions.) Top-rated vendor addressing this interoperability challenge: Waystar.
Incomplete Charge Capture Integration Cause: Delays and gaps in transferring clinical charges from EHR systems into patient accounting platforms. Impact: Lost or inaccurate charges, revenue leakage, and costly rework. (77% of respondents identified charge accuracy and revenue leakage issues as major concerns before implementing integrated systems.) Top-rated vendor addressing this interoperability challenge: Craneware.
Denials Data Silos Cause: Lack of structured denial feedback flowing across front-end and mid-cycle departments. Impact: Repeated errors in pre-registration and documentation, low first-pass yield. (72% of organizations reported significant problems with denials and low first-pass claim yields prior to adopting improved interoperability processes.) Top-rated vendor addressing this interoperability challenge: FinThrive.
The survey also revealed key market trends driving solutions to address these interoperability gaps. Over 79% of participating healthcare organizations reported actively modernizing their revenue cycle infrastructure to improve data flow. Adoption of cloud-native platforms, artificial intelligence-enhanced integration layers, Fast Healthcare Interoperability Resources (FHIR) APIs, and vendor-agnostic middleware solutions were cited as increasingly vital to achieving sustainable interoperability.
"Success in revenue cycle management today hinges on the ability to achieve seamless, real-time communication between clinical, financial, and patient access systems," Brown emphasized. "Healthcare leaders are prioritizing solutions capable of delivering robust interoperability strategies, modular deployment, and clear, measurable returns on their investments in data exchange improvements."
The Black Book 2025 RCM Survey comprises responses from 11,550 U.S.-based users of revenue cycle management software, services, and consulting. The interoperability and data integration segment specifically reflects insights from 540 senior executives and professionals in revenue cycle operations, IT, access management, finance, and coding.
About Black Book Research:
Black Book Research is an independent healthcare technology and consulting research firm committed to providing unbiased, crowd-sourced performance evaluations. Since 2011, Black Book has conducted annual surveys involving users of software, outsourcing, and advisory services across the healthcare sector. Black Book does not accept vendor funding, advertising or influence in its evaluation process. For competitive research licensing information, contact research@blackbookmarketresearch.com. Complimentary industry reports are available at www.blackbookmarketresearch.com.
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SOURCE: Black Book Research
View the original press release on ACCESS Newswire:
https://www.accessnewswire.com/newsroom/en/healthcare-and-pharmaceutical/2025-revenue-cycle-leaders-confront-growing-financial-risks-from-pers-1043549
