The hospital network faced several challenges in managing inquiries in regards to medical benefits, stemming from a variety of factors including:

Turnaround Time and Resourcing
Often times responding to patient inquiries within a reasonable timeframe requires proper staffing and manual labor - resulting in less than ideal patient wait times.

Accuracy and Adjusting to Constant Updates
Keeping abreast of the frequent changes in health insurance policies and benefits is a daunting task for patients and staff. This becomes even more complex when you have to consider the wide range of health insurance plans to choose from, that each have a unique set of benefits and restrictions. Without fully understanding the intricacies on both sides, theres a high probability of patient misunderstanding or miscommunication from the provider which can be detrimental to both parties.

Lack of Transparency
Specifics around coverage are generally vague and buried within extensive documentation. Given the unstructured and fragmented nature of the data, providers are often times spending an excessive amount of their time, sorting through information in order to provide an adequate response.