Top Medical Billing Errors and How to Avoid Them

7/17/20252 min read

Medical billing is complex, detail-heavy, and constantly evolving. Even the most experienced teams can fall victim to common billing errors that result in denials, delayed payments, and revenue loss.

The good news? Most billing mistakes are completely avoidable—with the right systems, training, and oversight in place.

In this post, we highlight the top billing errors practices make—and share how to fix or prevent them before they cost you.

❌ 1. Incorrect Patient Information

The Problem:
A single typo in a name, date of birth, or insurance ID can lead to an automatic denial. These errors often happen during registration or data entry.

How to Avoid It:

  • Verify patient demographics at every visit

  • Use real-time eligibility tools

  • Train front desk staff to double-check entries

  • Use autofill/autocomplete cautiously in your EHR

❌ 2. Missing or Invalid Authorization

The Problem:
Some services require prior authorization—and if it’s missing or outdated, payers will deny the claim, regardless of medical necessity.

How to Avoid It:

  • Maintain an up-to-date prior auth list by payer and service

  • Confirm authorization before scheduling procedures

  • Track expiration dates and allowable units

  • Document auth numbers in the claim notes

❌ 3. Improper Coding or Unbundling

The Problem:
Using outdated CPT/ICD codes, failing to link diagnosis to procedure, or unbundling services can all trigger denials or audits.

How to Avoid It:

  • Stay current with annual coding updates

  • Use CCI (Correct Coding Initiative) edits to check bundling rules

  • Cross-train staff on proper modifier usage

  • Audit your top-used codes quarterly

❌ 4. Billing for Non-Covered Services

The Problem:
Not all procedures are covered by all payers—or they may only be covered under specific conditions. Submitting them without understanding the policy results in non-payment.

How to Avoid It:

  • Use real-time coverage verification tools

  • Know payer-specific LCD/NCD policies

  • Collect Advance Beneficiary Notices (ABNs) when appropriate

  • Flag high-risk codes for pre-check before submission

❌ 5. Duplicate Claims Submission

The Problem:
Sometimes resubmitting a claim without following the proper correction protocol causes it to be flagged as a duplicate—delaying payment further.

How to Avoid It:

  • Use claim tracking tools to avoid premature resubmissions

  • If resubmitting, mark claims as corrected and include the original claim reference

  • Wait for official denial or rejection before taking action

❌ 6. Incorrect Provider Credentials or NPI Mismatches

The Problem:
If the billing or rendering provider is not credentialed or properly linked to the group NPI, payers will reject the claim.

How to Avoid It:

  • Coordinate between billing and credentialing teams

  • Confirm provider status with each payer regularly

  • Use the correct taxonomy codes and group vs. individual NPIs

  • Update CAQH and payer portals promptly

❌ 7. Untimely Filing

The Problem:
Every payer has a window (sometimes as short as 90 days) in which claims must be submitted. Miss it—and you won’t get paid.

How to Avoid It:

  • Set automated alerts for timely filing deadlines

  • Use batch submission software with rejection alerts

  • Run weekly reports to catch unbilled encounters

✅ The Bottom Line: Billing Errors Are Preventable

The best defense against billing mistakes is a proactive process, not a reactive one.

Here’s how to safeguard your revenue cycle:

  • Train your team regularly on payer changes

  • Use technology to track, verify, and flag issues early

  • Perform monthly internal audits

  • Keep billing and credentialing departments aligned