Top 10 Medical Billing Mistakes That Cost Practices Thousands

Medical billing errors don’t just delay reimbursement—they can drain thousands from your bottom line each year. Whether you're running a private practice, a specialty clinic, or a non-healthcare business managing in-house claims, avoiding costly mistakes is key to protecting your cash flow.

Below are the Top 10 Medical Billing Mistakes we help clients avoid—and how you can stay ahead.

Avoid These Common Pitfalls to Improve Revenue Cycle Efficiency

1. Missing or Incorrect Patient Information

From wrong birthdates to incomplete insurance IDs, even small demographic errors can lead to denied claims.

Solution: Implement strict front-desk protocols for double-checking insurance cards, demographics, and eligibility before services are rendered.

2. Failure to Verify Insurance Coverage

Assuming a patient is covered is a gamble. Coverage may have changed or lapsed.

Solution: Use real-time insurance verification systems and always check eligibility before every visit.

3. Coding Errors and Outdated Codes

Using incorrect CPT, ICD-10, or modifier codes results in denials and underpayment. Even outdated codes from past years can create compliance risks.

Solution: Regularly train your coders and billing staff. Better yet, outsource to certified coding professionals like those at ACCORDPRO.

4. Unbundling Procedures

Submitting separate codes for services that should be billed under a single bundled code is not only costly—it may trigger audits.

Solution: Stay current with National Correct Coding Initiative (NCCI) edits and payer-specific bundling rules.

5. Under-coding or Over-coding

Out of fear of audits, some providers under-code and leave money on the table. Others over-code, risking compliance violations.

Solution: Conduct regular chart audits to align documentation with appropriate coding levels.

6. Late Claim Submission

Every payer has a timely filing window. Miss the deadline, and you could lose the right to collect.

Solution: Track claim deadlines by payer and set automated alerts. Partnering with ACCORDPRO ensures timely submission every time.

7. Ignoring Claim Denials

Denied claims are not the end of the road—but failing to appeal or resubmit them is like throwing money away.

Solution: Establish a denial management workflow. Analyze root causes and appeal when appropriate.

8. Inadequate Documentation

If the documentation doesn’t justify the billed service, the claim will be rejected or audited.

Solution: Ensure clinical documentation supports the level of service. Training your staff or having a dedicated chart review team can help.

9. Improper Use of Modifiers

Modifiers clarify services but using the wrong ones can confuse payers or trigger rejections.

Solution: Train staff on modifier use by specialty. Our certified billers at ACCORDPRO stay updated on payer rules.

10. Lack of Reporting and Analytics

Without visibility into KPIs like Days in A/R, denial rate, or first-pass resolution rate, revenue loss can go undetected.

Solution: Use billing dashboards and reporting tools. At ACCORDPRO, we provide monthly insights to keep your RCM performance on track.

Final Thoughts

Billing mistakes don’t just cost you time—they cost you thousands of dollars annually. By proactively identifying these common issues, you can significantly boost revenue, reduce denials, and strengthen compliance.

Whether you're a solo provider or managing a multi-specialty group, ACCORDPRO is here to support your success with expert Medical Billing, Credentialing, and Bookkeeping Services.

Need help fixing your billing workflow?

📞 Contact us at 425-215-0517 or visit www.accordpros.com to schedule a free consultation.