4 Medical Billing Errors That Can Affect Your Wallet

 In Health Insurance, Insurance Billing, Medical Billing

Watch out for these Medical Billing Errors

Getting medical treatment is not cheap, which is why you would do well to make sure you are getting the most out of your money. Make sure you are not being charged more than you should be paying. Check your medical bills to make sure you only pay for the services you received and no more.

Studies show that even your medical bill is not safe from errors. Many people are involved in the creation of your bill and the errors can start from any of them; from hospital personnel who take your information, to the doctors and nurses who keep track of your treatment and procedures, to the data encoders who assign billing codes to your bill. Human error can result in the omission or addition of incorrect information, recording a procedure that did not take place or the erroneously encoding of data.

These are common causes of errors when it comes to Medical billing:

[star_list] [list_item]1 UPCODING[/list_item] Think of this like upgrading. When a medical billing code is improperly changed to reflect a more expensive medical procedure instead of a simple one, or a consultation is recorded as a hospital admission or when generic brand medicine was used but you are charged for name-brand medicine, that’s “upcoding.”
[list_item]2 UNBUNDLING[/list_item] This happens when charges that aren’t supposed to be billed separately are billed separately; for example, when multiple medical tests which should have been bundled in one code, are charged as different items.[list_item]3 DUPLICATE BILLING[/list_item] This can occur when any service or procedure is reflected and charged more than once. Duplicate billing can apply to anything from costs for medicines that are charged during prescription and administration, procedures that are listed more than once, and even visits to the doctor which are over-recorded.
[list_item]4 INCORRECT PATIENT INFORMATION[/list_item] Simply recording your name or your insurance policy number wrong can lead to problems. Your insurance provider may think they are not dealing with an actual customer and you might not be accorded the benefits due to you.
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Huge bills cannot be blamed on hospital staff error alone.

Your insurance can also be part of the problem if it has already been maxed out or does not cover certain services which are then reflected in your bill. How do you make sure you only pay for what you got?

[check_list] [list_item]Review your personal information. [/list_item]Make sure your insurance service provider has the correct and up-to-date information on you; compare and be certain that information matches with the information on your medical bill.
[list_item]Verify that the dates of services on your bill are correct. [/list_item]Sometimes it all boils down to whether a procedure, visit or consultation and even hospitalization actually took place or not. Be sure you were really there when they said you were.
[list_item]Check for duplicate billing. [/list_item]This is the most common of errors so this is something to watch out for.
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If you feel you are not competent enough to do this by yourself, or suspect that there are errors that go deeper beyond what you can comprehend, then get the services of professionals, like a personal insurance advocate, who can scrutinize your bill for errors. In the long run you will end up paying less instead of more.

Carol Gordon DeVore, M.D.

Carol Gordon DeVore, M.D.

Founder & Patient Advocate at Amazing Healthcare Consultants
Twenty nine years as a physician have brought me great personal and professional satisfaction, but a new passion has driven me to change directions within the healthcare system. I'm acutely aware of the confusion and frustration that patients face as they navigate the healthcare "maze" and look forward to helping patients in many new ways as a private healthcare advocate.
Carol Gordon DeVore, M.D.

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