Did you know that nearly 80% of hospital bills contain at least one error? In the healthcare industry, billing mistakes are not the exception—they are the norm.
Hospitals rely on complex coding systems (CPT and ICD-10 codes) entered by busy humans. Mistakes happen, but they often happen in the hospital's favor. If you blindly pay the "Total Due" at the bottom of the page, you might be throwing away hundreds of dollars.
Here are the 5 most common errors our AI detects, and how you can spot them yourself.
This is the most common and easiest error to find. It happens when a provider accidentally punches in a code twice, or when a nurse scans a medication, cancels it, and scans it again—but the system bills you for both.
How to spot it:
Look at your itemized bill. Do you see the exact same charge listed twice on the same date?
Upcoding occurs when a provider bills for a more expensive service than the one you actually received. This is illegal, but common.
How to spot it:If you went in for a routine checkup (15 minutes) but your bill lists a "Level 4" or "Level 5" visit (which implies a complex, life-threatening emergency), you have been upcoded.
Many medical procedures are supposed to be billed as a "package deal." Unbundling happens when a provider separates the steps of a procedure to charge you for each one individually.
How to spot it:
Imagine ordering a burger, but getting a bill for the bun, the meat, the lettuce, and the grilling service separately. That is unbundling.
Sometimes a doctor orders a test (like an X-Ray), but then decides you don't need it. However, if the order was already in the computer, the billing department might send the invoice anyway.
How to spot it:
Review every line item. Did you actually receive that MRI? Did you actually take that pill? If you don't remember it, question it.
Sometimes the error isn't medical; it's administrative. A misspelled name, a wrong digit in your insurance policy number, or an incorrect date of birth can cause your insurance to automatically reject the claim.
How to spot it:When you receive a bill for the full amount (meaning insurance paid $0), do not panic. First, check the top of the bill. Did they spell your name right? Did they have your correct policy number? A simple phone call can usually fix this.
You would never pay a restaurant bill that listed two dinners when you only ate one. Treat your medical bills with the same scrutiny.
If this sounds overwhelming, you don't have to do it alone. Bill Shield can scan your itemized statement, cross-reference the codes, and highlight these errors for you automatically.
