10 Most Common Medical Billing Errors You Can Catch Yourself
You don't need to be a medical billing expert to spot many of the most common errors on your healthcare bills. Studies show that 50% to 80% of medical bills contain at least one mistake—and many of those mistakes are surprisingly easy to identify once you know what to look for.
These errors can cost you hundreds or even thousands of dollars. The good news? Most of them can be caught with a careful review of your bills and some basic knowledge.
1. Duplicate Charges
What it looks like: You're billed twice for the same service, test, or medication.
How to spot it: Check your itemized bill for repeated entries with the same date and description. This often happens when records aren't properly synchronized between hospital departments.
Real-world example: You receive two charges for blood work on the same day, even though blood was only drawn once.
2. Unbundling (Fragmentation)
What it looks like: Charges for individual steps of a procedure that should have been billed as a single package.
How to spot it: Look for multiple separate charges related to one procedure when there should be a single "bundled" charge.
Real-world example: Instead of one charge for a complete blood count (CBC), you see separate charges for each component that's part of the standard CBC test.
3. Upcoding
What it looks like: You're billed for a more expensive version of the service you actually received.
How to spot it: Compare the service description on your bill to what you remember receiving. If the bill says "comprehensive exam" but you only had a brief follow-up visit, that's upcoding.
Real-world example: A 15-minute check-up is coded as a complex consultation requiring 45 minutes.
4. Wrong Patient Information
What it looks like: Your name, date of birth, or insurance information is entered incorrectly.
How to spot it: Always check the patient information section at the top of your bill and EOB (Explanation of Benefits).
Why it matters: Even small errors in your information can cause insurance to reject your claim, leaving you responsible for the full amount.
5. Charges for Canceled Services
What it looks like: You're billed for tests, procedures, or appointments that were canceled or never happened.
How to spot it: Cross-reference your bill with your own records of what actually occurred during your visit.
Real-world example: An MRI that was ordered but canceled before you had it still appears on your bill.
6. Incorrect Quantity
What it looks like: You're charged for more units of medication, supplies, or services than you actually received.
How to spot it: Check quantities carefully. If your bill shows three days in the hospital but you were only there for two, or five doses of medication when you only received three, that's an error.
Why this happens: Administrative mix-ups, computer glitches, or data entry mistakes.
7. Balance Billing from Out-of-Network Providers
What it looks like: You receive a bill from a provider you didn't choose—often an anesthesiologist, radiologist, or assistant surgeon—who was out of your insurance network.
How to spot it: Look for bills from providers you didn't directly schedule appointments with, especially after surgery or emergency care.
Important note: The No Surprises Act offers protection against many surprise bills as of 2022. You shouldn't be balance-billed for emergency services or for out-of-network providers at in-network facilities in most cases.
8. Incorrect Insurance Information
What it looks like: Your insurance policy number, group number, or coverage details are entered wrong.
How to spot it: Verify all insurance information on your bill matches your insurance card exactly.
Why it matters: Insurance companies will reject claims with incorrect policy information, and you might receive bills for amounts insurance should have covered.
9. Charges for Services You Declined
What it looks like: Bills for optional services or tests that you discussed with your doctor but decided not to have.
How to spot it: Review your itemized bill carefully and question anything you don't remember receiving.
Real-world example: You discussed genetic testing with your doctor but decided to wait. The test appears on your bill anyway.
10. Coding Errors
What it looks like: The wrong medical code is used for your diagnosis or procedure.
How to spot it: This can be harder to identify, but watch for service descriptions that don't match what you received. You can also compare the codes on your bill to your medical records.
Why it matters: Wrong codes can cause insurance denials or result in you being charged for services that should be covered at different rates.
How to Check Your Bill
Here's a simple process you can follow:
Step 1: Request an itemized bill (not just a summary) from your provider.
Step 2: Get your Explanation of Benefits (EOB) from your insurance company.
Step 3: Compare the three documents: your itemized bill, your EOB, and your own notes about what happened during your visit.
Step 4: Highlight anything that doesn't match or seems questionable.
Step 5: Contact the billing department to discuss any errors you've found.
When to Get Help
Reviewing medical bills is time-consuming, especially if you're dealing with multiple providers or complex treatments. Some errors require expertise to identify—particularly coding issues or problems with how insurance processed your claim.
Many families use automated claim monitoring services to help catch these errors. Services like HealthLock review your claims as they come in and alert you to potential problems before you get stuck with an incorrect bill.
Your Rights
You have the right to:
- Request itemized bills
- Question any charge you don't understand
- Ask for corrections to billing errors
- Request payment plans while errors are being resolved
Don't feel pressured to pay a bill immediately if something doesn't look right. Most providers are willing to put your account on hold while investigating potential errors.
The Bottom Line
Medical billing errors are extremely common, but many can be spotted with careful review. You don't need specialized knowledge to catch duplicate charges, incorrect quantities, or services you never received.
Taking the time to review your bills might feel like one more burden when you're already dealing with health issues. But catching even one error can save you significant money and stress.
Don't Let This Happen to You
Catching billing errors before they impact your finances is crucial. HealthLock automatically scans your claims for overcharges, duplicate billing, and coding errors, alerting you to problems before they become major headaches. HealthLock's members have saved over $243 million by catching billing errors, denied claims, and fraud before they became major problems.
Disclaimer: We're not medical billing experts or attorneys—we're patients and caregivers sharing resources to help you navigate a broken system. This information is for educational purposes only and should not be considered medical or legal advice.
Affiliate Disclosure: This site may contain links to services like HealthLock that help monitor medical claims and billing. We may earn a commission if you sign up through our links, at no extra cost to you. We only recommend services we believe can genuinely help.