Medical : Billing Errors Costing You Money

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MEDICAL BILLING ERRORS COSTING YOU MONEY
L S Coding Education LLC
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• As communication between medical coders and the
  providers of healthcare grows apart, medical
  billing errors are becoming more and more common.
• On the next few pages, we are going to outline
  some of the most common errors that could be
  inflating your medical bill.

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UPCHARGES
This first error is extremely illegal and can
definitely cause your bill to go through the
roof. Upcoding is when a medical code is
substituted for the wrong code with a pricier
diagnosis or treatment. Examples Coding a
generic medication as a name-brand. Coding an
office visit as an inpatient stay.
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SEPARATELY BILLED ITEMS
In many instances, many medical items are billed
in a bundle. Coding these items separately,
instead of in a package, can inflate your
bill. Example A group of small tests that are
considered a part of a greater test billed as
separate tests.   Contact a medical billing
advocacy company to help identify if this is an
issue on your bill.
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DUPLICATE PAYMENTS
This is exactly what it sounds like. Duplicate
billing is getting billed for the same item
multiple times this is one of the most common
errors. It can happen by a nurse and a doctor
recording the same item without
checking. Example The same medication billed
when prescribed and when administered.
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NOT OF MEDICAL NECESSITY
This error occurs when a medical provider
supplies the medical coder with very little
information about your diagnosis, causing the
coder to bill you for the wrong
item. Example Lack of medical necessity can
usually cause your insurance company to deny your
claim, and can leave you with the entire bill.
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BILLED FOR COVERED TREATMENT
When you receive a medical bill for the balance
after your insurance has paid its portion is a
normal and correct procedure. What is not normal
or correct is being billed for procedures that
should be paid by your insurance company under
your policy. Example You should not pay for
medical expenses that your insurance company is
supposed to cover. Contact your insurance
company to rectify the situation.
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INACCURATE PATIENT INFORMATION
This is also one of the most common
mistakes found your medical provider misspells
your name or incorrectly inputs your insurance ID
number. The insurance company will reject the
claim. The fix is relatively easy but can take
some time, as there are many people influencing
medical bills.
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DIAGNOSIS AND TREATMENT CODES TO DO MATCH
Diagnosis and treatment codes not matching can
cause your insurance company to reject the
claim. Here is an especially nasty example A
diagnosis medical billing code is upcharged, but
the treatment code remains the same. Not only is
the claim rejected, but you will have to pay more
for the item because it has been inflated by the
upcharging.
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CONTACT US

• L S Coding and Education LLC is unlike any other
  medical coding program. Lynn Schoeler, Instructor
  and President, provides an AAPC Professional
  Medical Coding Curriculum used in the
  Professional Medical Coding Program. For the past
  20 years, Lynn has educated coders and healthcare
  professionals.
• For more information on medical coding education,
  please contact [phone] or visit
  http//cpc.certifiedcodertraining.com/.