8 Common Medical Billing Errors

Billing is never an enjoyable process. For anyone. On average, 40 percent of small businesses are 60-plus days delinquent on at least a third of their receivables – and unclear or incorrect invoices can certainly be at fault.

In the medical field, reports say that upward of 80% of invoices are overcharging patients. To ensure you’re not making errors and overcharging your patients, keep in mind the following tips (or share these tips with them and build further trust):

1. Double charging:

Whether you refer to it has double charging or duplicate billing, this error occurs when patients are billed more than once. Human error is the most common example, say, through a doctor and nurse not fully communicating to each other that a particular medication was given – thus a bill could be incurred when the medication was prescribed and administered.

Another common example is billing multiple “first days” in a hospital, which often cost more than subsequent days during a hospital stay. Patients should always carefully read through invoices,  as double charging is the most common reason for unexpectedly higher medical bills. To combat this issue, insure your patients receive an itemized bill, making it easier to spot duplicate charges.

2. Upcoding or mismatched codes:

Upcoding occurs when a medical billing code is improperly changed to one which represents a more severe diagnosis or treatment. While the most common occurrences include things like coding a regular checkup as inpatient care or coding for name-brand versus generic medication, the error of upcoding is still a serious offense. To your patients, it’s basically like getting billed for an expensive bottle of Advil instead generic Acetemenophin….but much worse. And highly illegal. Patients should ask their healthcare providers to correct the charge immediately.

Mismatched codes are another similar error. When a medical bill upcodes your diagnosis, but a patient’s treatment code is left alone, the insurance company will typically reject the patient’s claim due to the mismatch between the treatment and diagnosis codes. This is a double whammy; not only will a patient’s bill be more expensive, but the claim will also get rejected.

3. Unbundling:

Unbundling is the separation of charges that are normally charged under the same billing code. Instead of receiving a package rate for, say, multiple tests of the same code, patients who experience unbundling on their medical bill can often pay multiples of their original bill.  This type of mistake can be tricky to identify, and patients who experience unbundling should reach out to the National Correct Coding Initiative by the Centers for Medicare and Medicaid Services for further advice on arguing the charges.

4. Incorrect quantity:

This mistake could be as simple as an extra “0” placed at the end of a number. Patients should carefully check quantity to make sure they weren’t charged extra for an incorrect amount of items or medications. Talk about a headache for the patient.

5. Incorrect info:

Another of the most common billing errors are simple misspellings and misprints, including incorrect names or policy numbers. Claim denials or being bill for a full amount can occur because of a simple incorrect insurance ID number. Talk about a headache.

The main reason these errors occur are because of how many hands influence a medical bill – sometimes up to a dozen people have something to do with it. One mistake entering incorrect information can be passed down the line just like the childhood “telephone” game, causing severe problems when a patient’s claim is submitted to their insurance company.

6. Balance billing:

Balance billing occurs when a health care provider bills the patient for charges other than co-pays or any other amount than what was negotiated with the insurance company. Balance billing is most common when a patient is treated “out-of-network” for non-emergency care, as doctors can set the rate to charge the patient and bill them for anything over the agreed amount. 

Patients should check with their insurance company about whether or not all of the hospital’s charges are covered under their policy. If they are, then this balance bill is illegal, and patients should not have to pay for it.

7. Overcharge time:

After undergoing a procedure, patients should check medical records to confirm how long they were in the operating room or under anesthesia. Patients are usually billed in 15-minute increments, therefore, mistakes can add up quickly.

8. Canceled procedures:

Patients can sometimes accidentally be charged for a test or procedure that ended up being canceled. They should make sure this doesn’t happen by carefully reviewing their itemized medical bill. If a patient thinks they were wrongfully over-billed, they should collect all the necessary documents to prove they did not receive the service, thus disputing the charge.

Related: How Do I Fix Medical Bill Errors?
Future of healthcare

5 Healthcare Innovations to Watch For in 2016

Back in October, Cleveland Clinic released their 10th annual list of the Top 10 Medical Innovations for 2016.  The list included such marvels as faster vaccine creation methods, a process for rewriting genetic code and even a highly detailed, affordable system for bringing water purification to developing countries.

Now that it’s finally the New Year, we thought we would dig up the list and bring to you five of the top 10 and what you can expect to hear in health care news in 2016. Here are the five (in no particular order):

1.) Naturally Controlled Artificial Limbs



If you remember back to late 2014, a story broke of a double-amputee man operating two artificial robotic arms using his mind. Les Baugh (pictured right) was able to move, and feel, everyday objects using the robotic arms and fingertip sensors. The video went viral.

Since then, researchers have discovered that neural signals associated with limb movement can be de-coded by computers. In Sweden, scientists have also unveiled the first mind-controlled prosthetic arm directly connected to a man’s natural bone, nerves and muscles.

More recently, researchers have demonstrated that sensors implanted in the brain can control prosthetic arms, wheelchairs and even a full body exoskeleton. It’s only a matter of time until such prosthetics are produced on an affordable scale, potentially helping millions of amputees worldwide.

2.) Water Purification System and Developing Countries

According to the World Health Organization, over 700 million people worldwide are drinking unsafe water everyday due to large amounts of sewage pools in cities. That’s ridiculous, right? Well, a new sewage processor plant may offer the next affordable solution.

In Dakar, Senegal, health officials say they’re testing a new type of waste treatment plant that would essentially turn these seeping sewage pools into sources of clean drinking water. The processor, which will cost roughly $1.5 million, would be able to support the waste of nearly 100,000 people a day.

Researchers think more processor plants like the one in Dakar will begin showing up in 2016.

3.) Battling Epidemics with the Rapid Development of Vaccines

Researchers are developing effective vaccines faster than ever to prevent epidemics. It’s an effort given new urgency by the 2014 Ebola epidemic in Africa and of Meningococcal B outbreaks in America. According to Steven Gordon, MD, chair of the Department of Infectious Disease at Cleveland Clinic:

“The rapid scientific response to recent epidemics indicates that we’ve achieved a new level of sophistication in the area of vaccine development. It was a global effort involving thousands of people, aided by information technology and instant communication.”

The most promising Ebola vaccine emerged in only 12 months. While it has not yet been licensed for human use, Cleveland Clinic experts estimate a safe, effective Ebola vaccine will be available this year.

4.) CRISPR Offers a New Spin on Gene Editing

Altering the DNA of human embryos has long been associated with that of science fiction. Now, with a new, inexpensive technique, “clustered regularly interspaced short palindromic repeats,” or CRISPR (which sounds a lot cooler), gene editing is being adopted by labs everywhere.

CRISPR is boasting the ability to eliminate a whole range of genetic diseases. It can more quickly develop and test cures, identify and remove bad genes from a DNA strand, and can cost as little as $30.

Great, but how is it being tested?

CRISPR is now being used in animal testing models but could eventually be used for a wide range of human applications, from treating debilitating genetic diseases to increasing food crop yields. What’s clear is that CRISPR’s impact on the human population will be immeasurable.

CRISPR is now being used in animal testing models but could eventually be used for a wide range of human applications, from treating debilitating genetic diseases to increasing food crop yields.

5.) Protein Biomarker Analysis and Cancer Screening

A new biomarker platform hits the market this year and will offer more accurate cancer screenings and better chances for early detection. Protein biomarker analysis focuses on changes in the structure of certain proteins circulating in the blood, so that, as opposed to examining genetic mutations, which can indicate the risk of cancer, these new tests give real-time information on cancer’s presence.