Medical billing errors cost Americans billions annually. Learn what to look for so you don't overpay.
Medical billing is complex. Most patients don't review their bills carefully — and hospitals and insurance companies know this. Studies suggest 80% of medical bills contain at least one error.
This guide breaks down the 10 most common billing errors we find when auditing patient bills. For each error, you'll learn what it is, how to spot it, and what to do about it.
The same service, procedure, or supply is billed multiple times. This can happen accidentally (data entry errors) or deliberately. Common examples include billing the same lab panel twice, charging for the same office visit on consecutive days, or repeating the same supply charge.
A patient was charged $456 for a complete blood panel on two separate line items. The total should have been $228. Saved: $228
A provider bills for a more expensive service than what was actually performed. This is sometimes accidental (billing staff doesn't know the correct code) but can also be intentional. For example, billing for a comprehensive office visit when you only had a brief check-up.
A patient was billed for a level 5 established patient visit ($285) when their visit lasted less than 5 minutes. Level 1 would have been appropriate ($75). Saved: $210
Related services that should be billed together under a single code are instead billed separately. This increases the total charge because individual codes often don't reflect the discount that applies to bundled services. Lab panels are a common example — some individual tests cost much more when unbundled.
A patient was billed $847 for individual chemistry tests. The same tests as a bundled metabolic panel would have cost $156. Saved: $691
You receive care at an in-network facility from an out-of-network provider, and then you're billed for the difference between what the provider charged and what your insurance paid. The No Surprises Act (effective 2022) protects patients from this in many scenarios, but violations are still common.
A patient received a $4,200 balance bill from an out-of-network anesthesiologist at an in-network hospital. Under the No Surprises Act, this was reduced to $380. Saved: $3,820
The provider bills you the full "chargemaster" rate instead of the negotiated contract rate with your insurance. This happens when billing staff doesn't properly verify your insurance coverage or enters incorrect information.
A patient was billed $12,400 for an MRI at the full chargemaster rate. Her insurance's contracted rate was $3,800. Saved: $8,600
Services, medications, or supplies that appear on your bill were never actually provided to you. This can range from minor items like gauze pads to major services like surgeries or extended hospital stays.
A patient was billed for 5 days of hospital stay when records showed she was discharged after 3 days. Saved: $14,200
Incorrect CPT (procedure) or ICD-10 (diagnosis) codes are used. Even a single wrong digit can change the meaning entirely. These errors often result in incorrect insurance processing or inflated charges.
A patient was billed for an arthroscopic meniscectomy ($4,500) when a simple joint injection ($280) was actually performed. Saved: $4,220
Under federal law, Medicare will not pay for treatment of certain hospital-acquired conditions that could have been prevented (called "never events"). Some commercial insurers have similar policies. These costs should not be passed to patients.
A patient developed a catheter-associated UTI during hospitalization and was billed $8,400 for treatment. This should have been covered by the hospital. Saved: $8,400
Simple data entry errors — wrong date of birth, wrong insurance policy number, wrong name spelling. While this might seem minor, it can cause insurance claims to be rejected, leading to you being billed instead of (or in addition to) your insurance.
A patient was incorrectly entered as "self-pay" due to a Social Security number typo. Once corrected, insurance covered $6,200 that she'd already paid. Saved: $6,200 (refund)
Nonprofit hospitals are required to offer financial assistance (charity care) to qualifying patients, and must inform patients about these programs. Many hospitals fail to advertise this, and patients miss out on reductions or even complete bill forgiveness.
A patient with a $22,000 hospital bill applied for financial assistance and received a 70% reduction under the hospital's sliding scale program. Saved: $15,400
Our AI-powered audit finds these errors automatically. Most patients discover errors worth disputing — and save money.