Top Challenges for Patient Access Leaders | FinThrive

Patient access is vital to care delivery, patient satisfaction, and hospital efficiency. Yet, despite advancements in technology, challenges remain.

Here are five key issues patient access leaders face today—and practical solutions to overcome them. 

1. Staffing Shortages and Turnover

One of the main challenges hospitals face is not having enough experienced and trained staff to manage patient access functions. Skilled staff are essential for handling patient registrations, answering calls, verifying insurance and guiding patients through the process.

However, many hospitals report they’re understaffed report that they are understaffed, which leads to longer wait times for patients and increased stress on existing employees. In fact, 50% of patient access leaders noted that managing staffing shortages was a top priority for their department in the year ahead, according to 2025 survey data from FinThrive.

High staff turnover is another issue. When employees leave frequently, hospitals must rely on temporary or agency staff to fill gaps. This can cost more, sometimes raising hourly wages and overall expenses. Temporary workers may not be as familiar with hospital systems or procedures, which increases the likelihood of errors, especially in critical tasks like verifying patient information.

How to Improve:

• Adopt AI and Automation: By using artificial intelligence (AI) and automation tools, hospitals can offload repetitive and routine tasks such as data entry, appointment reminders and insurance checks. This allows staff to focus on more complex patient needs and reduces their workload.

• Offer Text-Based Solutions: Not all patients have reliable internet access or feel comfortable using patient portals. Implementing text-based communication makes it possible for more patients, including seniors and those with limited resources, to access services without barriers.

• Cross-Training and Role Rotation: Hospitals can train staff in multiple disciplines and rotate them between roles. This reduces burnout, creates a more flexible workforce and lowers the dependence on expensive agency staff.

• Employee Incentives: Offering incentives such as flexible schedules or recognition programs can help retain staff and improve morale.

2. Errors Leading to Claim Denials

Another major area of concern is claim denials caused by simple errors during patient registration. For example, if a staff member enters the wrong insurance number or misses important information, claims get denied by insurers. Hospitals then have to rework and resubmit these claims, which costs them time and money.

Many hospitals still use older automation tools that were designed to mimic human keystrokes. These tools are often not smart enough to detect subtle errors or adapt to changes in forms or software. As a result, mistakes go unnoticed until claims are denied, leading to lost revenue and administrative strain.

The frequency of denials is climbing in recent years, making this a significant financial and operational issue for healthcare leaders.

How to Improve:

• Use Real-Time Eligibility Bots: Automated eligibility checks updated in real time can help catch errors at the point of registration or before claims are submitted. This saves both time and money by preventing errors instead of fixing them later.

• Apply Advanced AI Tools: AI-powered systems can read and analyze clinical notes and documentation more accurately than older tools. They can flag inconsistencies, missing details and potential reasons for denial before the claim is sent.

• Integrate Eligibility Checks with Estimates: When eligibility verification is connected directly to cost estimation, staff receive immediate feedback on possible issues, allowing for corrections at the earliest stage.

• Continuous Training: Providing ongoing training and updates for staff helps ensure they’re familiar with the latest requirements and best practices for data entry.

RELATED: Master Claims Denials: A Checklist for Patient Access Leaders

3. Digital Tools Not Reducing Wait Times

Many hospitals have invested in digital front doors—patient portals, online scheduling and automated phone systems—to make it easier for patients to get care. However, for many patients, these changes haven’t translated into faster or smoother experiences. Long phone wait times are still common and not enough patients take advantage of online scheduling tools.

Some patients start filling out forms or scheduling appointments online but soon hit obstacles. For example, they may be asked to call the hospital to finish a process, which leads back to long wait times. Others may lack the digital skills or access needed to use online tools.

There are also equity issues. Older adults, people with limited English or those without internet may not use digital systems as often. This can widen disparities in care.

How to Improve:

• Simplify Access with SMS and Web Links: Allow patients to schedule or verify appointments through text messages or simple web links. Avoid making patients go through multiple steps or logins for basic tasks.

• Use AI to Predict Demand: AI tools can help hospitals forecast when more staff might be needed based on predicted no-shows, appointment types or seasonal trends. This improves scheduling and reduces bottlenecks.

• Monitor Access by Group: Track which patient groups are using digital tools and address gaps. For example, if fewer older adults are using online scheduling, offer training or alternative ways to access services.

• Provide Clear, Step-by-Step Guidance: Plain instructions and easy navigation can help users complete online processes without confusion.

4. Prior Authorization Delays

Prior authorization is the process of getting approval from insurance companies before certain treatments or tests can be performed. This step is intended to control costs and ensure appropriate care, but in practice, it often causes frustration for both patients and staff.

Getting these approvals can take days, leading to delayed care and extra administrative work.

How to Improve: 

• Use AI-Based Authorization Platforms: Modern AI platforms can automate much of the prior authorization process. They match clinical information to payer rules and can submit requests automatically, reducing manual work and speeding up decisions.

• Clinical Validation Before Submission: Review patient charts against payer guidelines before sending requests. This can reduce the chance of denial and avoid wasted time.

• Track Denials and Appeals: Keep records of which denials are overturned and use this data to push for broader authorization waivers with insurers.

• Educate Staff on Changing Rules: Make sure staff are aware of evolving requirements and best practices for faster authorizations and fewer delays.

4. Prior Authorization Delays

Prior authorization is the process of getting approval from insurance companies before certain treatments or tests can be performed. This step is intended to control costs and ensure appropriate care, but in practice, it often causes frustration for both patients and staff.

Getting these approvals can take days, leading to delayed care and extra administrative work.

How to Improve: 

• Combine Data for Accurate Estimates: Use software that brings together contract terms, insurance details and past payment histories to deliver precise estimates quickly.

• Send Estimates and Payment Links via Text: Let patients receive their estimates and pay via their phones, using straightforward and user-friendly interfaces.

• Track and Learn from Issues: Analyze collections and denials to identify trends or common errors in estimating and make ongoing improvements.

• Regularly Update Pricing Information: Review and update posted prices and estimates as regulations or costs change to stay compliant.
• Train Teams to Explain Costs: Staff should be ready to help patients understand their estimates and answer questions about charges.

By investing in smarter technology, simplifying patient interactions and closely monitoring key measures, patient access leaders can make real progress. This leads to better service for patients, more efficient operations and improved financial health for the organization.

Solving these challenges may not be quick or easy, but step-by-step improvements will have a noticeable impact on both patient experience and hospital performance.

FinThrive’s patient access tools help you deliver a smoother experience for patients while strengthening operational performance. Learn more about the value we provide.