Table 2. Identified themes and subthemes based on framework analysis .

Theme	Subtheme
Bottlenecks	- Outpatient departments - Surgical Units, operating rooms (surgery and anesthesia) - Hospital hotel services - Inpatient consultation by specialists - Inpatient documents - Paraclinical departments such as radiology and laboratory
Direct causes of revenue deficits	- Poor clinical documentation - Failure to submit complete, timely and accurate financial documentation - Inconsistencies in documents and reports - Not complying with the regulatory requirements of the insurer organizations
Root causes of revenue deficits	- Infrastructure challenges and issues - Poor regulatory systems -Limited awareness and knowledge of healthcare providers about financial cutbacks and insurer regulations - Insufficient interaction between hospitals and insurance organizations - Service providers’ lack of incentive to control deductions (Moral Hazard)
Revenue deficits Management Strategies	- Analysis, assessment and feedback on revenue deficits - Organization of human resources - Coordinating and empowering the service employees - Interaction with insurance organizations - Strengthening regulatory systems - Motivate workforce - Good planning - Creating an organizational structure
Challenges and barriers to reducing revenue deficits	- The clinicians' refusal and senior managers' reluctant for involving - Outsourced units deductions at the hospital - Lack of coordination among representatives of insurance organizations - Based on the staffs' idea, the non-logical relationship between the deductible amount and the refunded amount - The insufficient collaboration of Vice- Chancellor in Treatment Affairs