Learn to Spot Common Medical Billing Errors

You might be surprised at how many mistakes are lurking within your medical bills – mistakes with costs that add up to significant amounts of money that you are expected to pay. It is important to learn how to not only recognize the most common medical billing errors but understand the best way to handle them when you do run across them. A little bit of skepticism and detailed observation may save you hundreds (and maybe even thousands) of dollars on your medical expenses.

Billing for Services That Were Not Rendered

Make sure that you are not being billed for services that were not rendered, including procedures or appointments that you canceled. This mistake is more common than you may think and goes unnoticed if you do not carefully inspect your EOBs (Explanation of Benefits). If you do see a questionable charge, contact your medical provider so that they are aware of the mistake and ask for a revised bill. If they refuse to correct a mistake, then contact your medical insurance company for help.

Duplicate Billing

doctor's schedule

Duplicate billing means that either your medical provider is billing you for the same service twice or two separate providers are billing you for the same service. This is not usually an intentional act: it could be that a doctor and a nurse both noted in your records that a blood draw and testing was performed and the billing department, not realizing that both notes refer to the same procedure, issued two different bills.

Similar to duplicate billing, you may mistakenly be charged for the wrong quantity of medical items or medications. This is especially common with hospital bills and often shows up with an extra 0 placed after a quantity (e.g., 5 becomes 50 or 25 becomes 250).

If you discover either a duplicate billing or an incorrect quantity mistake, contact your medical provider’s office and ask them to issue you a corrected bill.

Wrong Coding

Stethoscope and laptop

Another common medical billing error is incorrect coding. Medical coders are responsible for translating your physician’s notes into codes that classify the reason for your visit, what diagnoses you received, and what procedures were performed on you during your visit. If a medical coder miscodes the physician’s notes for your visit, this can result in a higher bill. In some cases, codes may be upcoded to represent a more costly treatment or procedure than what you actually had. If you suspect this type of error has occurred, you should do some research before you contact your physician for an amended bill. Check the IDC-10 codes and current procedural terminology, or CPT, before you contact them.

Incorrect Patient Information

If your medical provider has your insurance ID number, policy number, or name recorded incorrectly, it can lead to denial of insurance claims or very high medical bills. These kinds of mistakes lead to serious billing issues because your claims aren’t properly sent to your medical insurance company. If the amount you are being charged seems unreasonable, take the time to check the patient information details and notify your physician’s office if you do find an error.

Balance Billing

bookkeeping

Here’s what you need to know about balance billing: it refers to charging you an outstanding balance after your insurance has paid its portion and you have paid your copay or deductible. Balance billing is allowed when you see an out-of-network provider (even if the facility is in-network) or visit an emergency room where you were seen by medical personnel who were not in-network even though the hospital is. In most states, balance billing is illegal as long as you are seeing an in-network provider and receiving services that are covered by your insurance.

One way to detect balance billing is to compare your EOB with your actual medical bill. If you are legally balance billed, you can attempt to negotiate to get a portion of your balance forgiven, often by setting up a payment plan or paying a portion of the bill upfront. If you believe you have been illegally balance billed, contact your insurance company for help. They can take the necessary legal steps to put a stop to this illegal billing.

Conclusion

Medical billing errors are a common problem and are usually the result of oversight rather than an intentional attempt to defraud you. However, those errors and the overcharges that result from them still need to be addressed, and corrected bills provided. In most instances, you can contact your medical provider’s office directly to resolve the issue, but in some instances you may need the help of your insurance company. The important thing to remember is that these medical billing mistakes will not be fixed unless you take action.

Consumer Medical Bill Solutions

If you are feeling overwhelmed by medical debt, contact Consumer Medical Bill Solutions today. We can help you reduce your medical debt by 25% to 45% (sometimes up to 75%), and that includes both network and non-covered expenses. We will negotiate on your behalf to reduce your overall medical debt and stop the collection efforts against you or eliminate the risk of balance billing. Our process is straightforward: fill out a contact form, talk with one of our customer service team members, sign the necessary releases, provide us with the documentation of your medical bills, and let us negotiate a settlement for you. Contact us today!