8 Medical Bill Errors You Need to Watch For
From duplicate charges to typos, don't pay extra due to these goofs
(This article previously appeared on Nerdwallet.com.)
Millions of Americans are potentially overpaying on their medical bills because of eight common errors — from duplicate charges to incorrect insurance ID numbers. Inaccuracies with any one of them could result in thousands of dollars wrongfully added to your final bill.
In fact, mistakes on medical bills may be more widespread that many consumers realize, according to Pat Palmer, founder of Medical Recovery Services, a national organization that helps patients identify and correct medical bill errors.
“It’s astounding that eight out of ten hospital bills we receive contain numerous overcharges,” Palmer said.
(MORE: How to Negotiate Doctor Bills)
So, bring a healthy skepticism to any medical bill you receive by carefully checking for common errors to ensure that you are paying the right amount. By looking out for them, you can protect yourself from potentially paying thousands of dollars in unnecessary costs.
Spotting 8 Common Medical Bill Errors
After visiting your medical provider, you’ll receive an invoice telling you how much you owe. However, because errors are common, request an itemized bill or statement from the hospital or your doctor. This way, you can carefully check each service you are being charged for.
If you have health insurance, you should also receive an Explanation of Benefits (EOB) statement from your health plan. Compare the EOB statement with your medical bill carefully. The EOB should provide details such as the type of service received, the date of service, the amount your health care provider billed your insurer, the total amount that was not covered and the total patient cost.
(MORE: Be Your Own Health Advocate)
Watch out for these eight common medical billing errors when you receive your itemized bill and EOB statement:
1. Duplicate charges: Carefully check to make sure you were not billed twice for a single service or procedure. With an itemized bill, this error should be much easier to spot.
2. Canceled tests or procedures: Review your itemized bill to make sure you weren’t charged for work that wasn’t done. If you think you were wrongfully overbilled, collect all the necessary documents to prove that you did not receive the service, so you can dispute the charge.
3. Incorrect patient information: Small errors such as wrong name spellings or policy number misprints are common on medical bills. If your insurance ID number is wrong, that can lead to a claim denial or your being charged an inappropriately high amount.
4. Upcoding charge: A hospital could inflate your diagnosis to one representing a more serious procedure, leading to a higher medical bill. For example, you could have received the lowest level of emergency room services but be billed at the highest level. This is an illegal, fraudulent practice and you should ask your health care provider to correct the charge immediately.
5. Unbundling of charges: This mistake refers to the separation of charges that should have been billed under the same procedure code. It can be tricky to identify unless you’re a certified medical bill coder, but you can reference the National Correct Coding Initiative by the Centers for Medicare and Medicaid Services if you suspect such a mistake on your bill.
6. Balance billing when in-network: Balance billing or extra billing is when a health care provider bills you for the difference between what your health insurer reimburses and what the health provider believes it should receive. It’s often improper when the care was provided by an in-network hospital or physician.
Balance billing is most common when you are treated out-of-network for non-emergency care, since doctors can set the rate to charge you and bill you for anything over what your insurance covers. If you think you’ve been balance billed, compare the bill with your EOB.
7. Incorrect quantity: Make sure you weren’t charged extra for the wrong number of medical items or medications. This mistake could be as simple as an extra “0” being placed at the end of a number by the billing department.
8. Operating room and anesthesia time: If you underwent surgery, check your medical records to see how long you were in the operating room or under anesthesia. Because patients are usually billed in 15-minute increments in these instances, mistakes here can add up quickly.
Andrew Fitch is a Senior Associate at NerdWallet Health, where he leads consumer engagement strategy.