At Allegiant Experts, we consult with and educate attorneys who fight against wrongful billing practices. Medical billing errors negatively impact both individuals and the larger health care industry. We also mentor health care delivery agencies that just want to get their billing right.
Medical billing errors occur more often than you may think. It’s important, of course, for patients to carefully scan their bills for any discrepancies between what is billed and what was expected. Let’s take a look at some of the most common medical billing errors.
To create a medical bill, a health care provider must use specific medical codes. These codes denote the types of medical treatments, procedures and/or products that patients receive. Often, coding errors simply occur by accident. When they do, they can create much higher bills for patients.
Upcoding is one of the most common coding errors committed by health care providers. This is when a provider mistakenly uses the wrong code on a medical bill. Doing so causes a patient and his/her health insurance plan to be charged for a more expensive procedure or product than the one he/she received. Of course, when a provider practices upcoding intentionally, it is illegal.
When a group of procedures occur together, they are supposed to be billed under one single code. Naturally, this is called “bundling”. When a provider “unbundles” by separating services into individual charges, it can create an overbilling.
Incorrect balance billing.
In some cases, patients have balances owing on their medical bills. This occurs when an insurance plan does not cover the entire amount of the procedure or product. However, there are instances when patients receive bills for balances that were paid in full. This is often the result of a mistake by the provider.
Charges for canceled or refused services.
Sometimes, patients refuse the medicines, tests, procedures or supplies offered to them by their physicians. Naturally, there should be no charges in such cases. There are times, however, when those cancellations and refusals go unnoticed and unexpected charges on medical bills appear.
Date and length of stay errors.
We know that hospital visits result in medical billings. So, it’s important for patients to carefully review their bills so that they reflect the accurate amounts of time they spent in the hospital. In some cases, patients are charged for overnight stays when they only stayed in the hospital for a few hours.
It is possible that a patient can be billed twice for one test, medical prescription or supply. This generally happens after a hospital stay or procedure. Duplicate charges are often mistakes as there is never a reason to pay for the same thing twice.
The Allegiant Experts team identifies facts, finds errors and illuminates the truth. We also ensure that we keep our clients informed during every step of the process. It’s part of our mandate to always provide our best and most qualified opinion as we strive to meet your needs. For more information about how we help to both dispute and minimize medical billing errors, please don’t hesitate to call us at 407-217-5831. You may also email us at firstname.lastname@example.org.