There are a number of reasons that make the process so complicated: There are a lot of steps involved in insurance verification and upping the antenna for possible error and potential delays. The payer (insurance carriers) and the providers (healthcare) do not have a standardized workflow. Payer rules are constantly changing and it is hard to monitor them and make revisions. It is further complicated by thousands of payers and health plans. Payers can keep adding to their health plans. Shortage of skilled staff means that experienced hands might not be available