Common Medical Billing Errors
Studies show up to 80% of medical bills contain errors. Here's what to look for.
Duplicate Charges
The same service, procedure, or supply billed multiple times. This is one of the most common errors, often occurring when different departments enter charges separately.
Example: Being charged twice for the same CT scan because both the radiology department and ER entered the charge.
Unbundling
Billing separately for services that should be grouped together under a single code. This artificially inflates the bill by charging for components individually.
Example: Charging for a Basic Metabolic Panel ($150) plus a separate Glucose test ($50), when glucose is already included in the panel.
Upcoding
Using a billing code for a more expensive service than what was actually provided. This is especially common with emergency room visit levels and evaluation codes.
Example: Billing for a Level 5 ER visit ($800) when the patient received routine care that warrants a Level 3 ($300).
Surprise / Balance Billing
Being billed for the difference between what an out-of-network provider charges and what insurance pays, often without your knowledge the provider was out-of-network.
Note: The No Surprises Act (2022) protects patients from many surprise bills for emergency services and certain non-emergency services.
Incorrect Patient Information
Wrong name spelling, date of birth, insurance ID, or policy number can cause claims to be denied or processed incorrectly, leaving you with a larger bill.
Tip: Always verify your personal and insurance information is correct on every bill before paying anything.
Phantom Charges
Being billed for services, tests, or supplies you never received. This can happen due to data entry errors or services that were ordered but cancelled.
Example: Being charged for a medication that was prescribed but you declined, or supplies for a procedure that was cancelled.
Excessive Markup
Hospitals often charge 5-10x or more the actual cost of supplies and medications. While some markup is normal, extreme pricing should be questioned.
Example: Being charged $50 for a single Tylenol pill that costs pennies, or $500 for a bag of saline that costs $1.
The Numbers Don't Lie
80%
of bills contain errors
$750
average overcharge
26%
denied claims are wrong
63%
never check their bills