Common Medical Billing Mistakes

Only when insurance claims get held up or denied, do the billing staffs try to trace out what went wrong. And then they realize that there has been some thing they have overlooked, a mistake that should have been corrected during the medical billing process itself. With the high cost of health care in the USA medical billing errors have often created situations that make some unfortunate client get wrong bills and makes him pay up more than he needs to. If in such situations the client does not have the necessary insurance documents in order, his condition becomes pitiable.

Tracking of billing mistakes is not always easy even for the billing professionals and is an assured impossibility for the naïve client/patient with not much technical knowledge about it. Quite often we have come across many a people wondering as to why a simple surgery did cost them a fortune. It is for the health care professionals to avoid such common billing mistakes which often amounts to just carelessness and could be caused by a flaw in the internal communication process. Here is a list of the most common billing mistakes that often becomes the cause for a delay or denial of the insurance claim / bill reimbursement.

• Wrong patient identification number
• Wrong ICD-9-CM code with out fourth / fifth digits when required
• Duplicate claim
• Wrong date of service
• Wrong rates charged
• Procedure of claim not fully furnished by the other party
• No match between the ICD-9-CM code and CPT code
• Physician's ID not available
• Billing for more Operating room time than used
• Type of service code not mentioned
• Billed for cancelled services / tests
• Bill amount totaling mistake
• Treatment/service provided was not validated
• Service/treatment given in an invalid center/place of service
• Service was not a medical necessity
• Place of service code not mentioned

Some of the suggestions given to reduce medical billings in physician offices include, having an auditor who is well-schooled in medical policy and terminology. Errors should be corrected immediately when found out and care must be taken to remember not to repeat the same mistakes again. It is always right to report an error to the government authorities even though one can be fined for it.

The author of this article is Ricci Mathew of Outsource Strategies International (OSI), a US based company that offers services in Medical Coding, Medical Billing, Medical Transcription for clients across the US.