Medical billing errors are so common they have become the rule rather than the exception. Here are the five types our reviewers catch most often, and why each one matters.
1. Duplicate Charges
The same procedure, medication, or supply billed more than once. It happens more often than you'd think, especially with multi-day hospital stays where different departments submit charges independently.
2. Upcoding
Billing for a more expensive procedure than the one actually performed. For example, charging for a Level 4 office visit when only a Level 2 was warranted. Each "level" corresponds to a different CPT code, and a very different price.
3. Unbundling
Breaking apart a package of services that should be billed together at a lower bundled rate, then billing each piece separately at full price. Common in surgical bills.
4. Balance Billing
When an out-of-network provider bills you for the difference between their charge and what your insurer paid, even when you had no reasonable way to know they were out-of-network (e.g., an anesthesiologist at an in-network hospital).
5. Wrong Patient or Wrong Date of Service
Administrative errors that assign someone else's charges to your account, or list the wrong date of service, which can affect insurance coverage determinations.