The paper tried to entangle the current puzzle on the implementation of the balanced scorecard, especially within a health-service provider. By positing two folding questions which address the possible antecedents for the successful balanced scorecard and how to perform each antecedent to deal with the current issue, the study begins with comprehensive literature reviews among more than 58 manuscripts from respective journals. Having performed the analysis in an objective manner, the study succeeded in identifying five possible antecedents as crucial elements to BSC: (1) vision and mission, (2) organizational fitness, (3) organizational capabilities, (4) technological support and (5) organizational commitment. Furthermore, in maintaining the objectivity, the study also analyzed major challenges faced in the health-service industry. Our findings portrayed three major challenges: (1) due to objectivity of the measurement process, (2) organizational capability’s consideration and (3) special organizational characteristics. Therefore, we enclosed the paper with proposing a firm model which can be used as future guidance for the health-service provider to implement the balanced scorecard, thus preparing the next stage for future research directions.