Navigating medical bills can be overwhelming, especially when something doesn’t add up. Billing errors are surprisingly common and can lead to unnecessary charges. Knowing what to look for—and how to fix it—can save you money and frustration. Here’s a breakdown of the most common errors and how you can tackle them.
1. Duplicate Charges
What to Look For:
Check your bill for the same service or procedure listed twice. This could happen if a service was accidentally coded or entered more than once.
How to Fix It:
- Review your Explanation of Benefits (EOB) or billing statement carefully.
- Call your healthcare provider or billing department and ask them to confirm whether it’s a duplicate charge.
- Request an updated bill if an error is found.
2. Incorrect Coding
What to Look For:
Medical billing relies on specific codes (like CPT and ICD-10 codes) to describe procedures and diagnoses. A simple typo can mean you’re charged for the wrong service.
How to Fix It:
- Compare the codes on your bill with the treatment or service you actually received.
- If you think there might be an error, contact the billing department where you had service. They will be more than happy to go over the charges and codes with you.
- If the code is wrong, contact the billing office and ask them to correct the error and resubmit it to your insurance.
3. Services You Didn’t Receive
What to Look For:
Occasionally, bills might include services or tests that you didn’t actually receive.
How to Fix It:
- Compare the bill with your medical records or appointment notes.
- If you see a charge for something you didn’t get, ask your provider for clarification.
- Dispute the charge in writing if necessary, providing documentation to support your claim.
4. Insurance Processing Errors
What to Look For:
Your insurance might deny a claim due to missing information, incorrect patient details, or miscommunication with the provider.
How to Fix It:
- Double-check your insurance information on the bill to ensure accuracy.
- Contact your insurance company to understand why the claim was denied or processed incorrectly.
- Resubmit the corrected claim if needed.
5. Out-of-Network Charges
What to Look For:
You might be billed at higher rates for services from providers who are out-of-network, even if you were referred there.
How to Fix It:
- Call your insurance company to confirm the network status of the provider.
- Consider appealing the bill based on circumstances, was it an Emergency Department visit, were you out of town on vacation, etc.
Pro Tips for Addressing Billing Errors
- Request an Itemized Bill: Always ask for a detailed breakdown of charges to catch errors more easily.
- Keep Records: Save all paperwork, including EOBs, receipts, and correspondence with providers and insurance companies.
- Know Your Rights: Familiarize yourself with your insurance plan’s coverage and appeal process.
Ask for Help: If the process feels overwhelming, don’t go it alone. Contact us for expert assistance. We’ll review your bill, identify potential errors, and guide you through resolving them—all starting with a free consultation!
Medical billing errors are frustrating, but with a little detective work and persistence, you can address them effectively. Remember, you’re not alone in this process—don’t hesitate to ask for help if you need it.