Medical Billing

Common Mistakes in Medical Billing and How to Avoid Them

Common Mistakes in Medical Billing

One of the most important – and often overlooked – aspects of running a successful medical practice is billing and coding. Proper billing and coding are essential in getting paid for the services you provide. it is a crucial process by which healthcare providers submit charges to insurance companies and patients for services rendered. The process can be complicated, and from coding to documentation, there are a number of common mistakes that can be made.

Common mistakes include billing for services that were not rendered, incorrect coding, and failing to obtain proper authorization. These mistakes can be costly and time-consuming to correct.

In this article, we will discuss the most common mistakes in medical billing and how to avoid them. Read on to learn more!

Common mistakes in medical billing

Common mistakes in medical billing

Since the medical billing process act as the fluid to a practice revenue, it is essential to get them streamlined in medical billing best practices in an efficient way. But mistakes happen. With limited resources, any situation can even contribute to increasing the chances of billing errors. Here are some tips and tricks to check if you are hitting the right options to automate your billing process.

Ensure patient information is accurate

One of the most important aspects of making medical bills is to ensure that all patient information is correct. This includes the patient’s name, date of birth, address, and insurance information. If any of this information is incorrect, it could delay or even prevent the patient from receiving the care they need.

It’s important to double-check all of this information before submitting any medical bills. By taking a few extra minutes to verify the accuracy of the information, you can help to ensure that your patients get the care they need in a timely manner.

Avoid upcoding

As a medical provider, you may be tempted to upcode your services in order to receive a higher reimbursement rate from insurance companies. However, this practice is considered fraud and can result in severe penalties, including prison time and cancellation of medical work license.

Upcoding is the practice of billing for a more expensive service than the one that was actually provided. For example, if you provide a patient with a basic level of care, you would bill for that service. But if you upcode the service, you would bill for a more expensive level of care, even though the patient only received the basic level of care.

While making medical billing, avoid upcoding by accurately coding the services provided and only billing for the services that were actually performed. If you have questions about the correct code to use, contact the insurer or check with a coding expert.

Utilize the latest medical coding manual

Utilize the latest medical coding manual

Using the latest medical coding manual, you can save time and money on medical billing. The National Uniform Claim Committee (NUCC) updates the medical coding manual every year, so it’s important to use the most current version. The latest medical coding manual can be found on the NUCC website.

There are a few things to keep in mind when using the medical coding manual. First, make sure you are using the correct version. The NUCC website has a list of all the current medical coding manuals. Second, be aware that some codes have been added, deleted, or changed in the latest edition. And finally, make sure you are using the manual in conjunction with other resources, such as the American Medical Association’s CPT manual.

By utilizing the latest medical coding manual, you can save time and money on medical billing. The AMA’s CPT® Manual is the most comprehensive resource available. Or, for a more specific focus, try one of the following:

– The ICD-10-CM Official Guidelines for Coding and Reporting

– The HCPCS Level II Codebook

– The CPT Assistant

All of these coding manuals can be found on the AMA website.


Avoid duplicate billing

Avoiding duplicate medical bills can be a trickier one. This happens when a patient is billed twice for the services they are provided with once. Duplicate bill, if caught, can lead not only to claim denials and rejections but they can also open up an inquiry for your practice.

The best possible thing to consider while avoiding duplicate bills is to run audits.

With continuous audits and checks on your bills, you will be aware of what you have been paid for and what lingers on the backend. Plus, it helps practices and organizations to remain organized in terms of billing and can avoid fraudulent rapport in the industry.

Verify insurance benefits and coverage

When you find yourself making medical bills, it is important to verify patient insurance benefits and coverage. Oftentimes, the reason for claim denials is inaccurate or out of dated information.

In addition, insurance companies change their policies regarding coverage and reimbursement continuously. For this reason, it becomes apparent to be on the verge of getting the information in first-hand.

Healthcare practices must verify the insurance benefits and coverage before submitting claims to avoid claim rejections. Once verified, contact the insurer team to confirm eligibility and co-payment information of the payer.

Hire a professional medical biller

Hire a professional medical biller

Professional medical billers are experts that work with the medical practice to prepare and code for the services they rendered.

A medical biller can help you receive reimbursement for your medical expenses, negotiate with your insurance company, and submit claims on your behalf.

While you may be able to save money by doing your own medical billing, it is important to note that medical billing is a complex process. As such, it is often best to leave it to the professionals. Medical billing services are often outsourced by medical practitioners for billing and coding accuracy. Leaving the complex process to the experts validates the accurate coding procedure and efficient reimbursement.


While dealing with the multifaceted medical billing process, it gets tough for practices to receive complete reimbursement for the provided services. However, no matter how efficient your billing team is, mistakes happen. Learn to avoid common mistakes in medical billing and how to avoid them by donning some simple audits and organizational management steps.