Beware of Medical Billing Practices

A new round of medical billing errors following a recent procedure that required several phone calls to straighten out, reminded me of the post below which I am re-issuing as a note of caution to always check your medical bills and your insurance statements carefully to ensure you are not over-paying. In my case, the provider sent a substantial bill for something that should have been covered 100%. For this procedure it is common for either the provider or the insurer to mis-code which results in erroneous charges or charges resulting from timing of billing versus reimbursement. After 2 rounds of calls I am hoping it is straightened out, but I won’t know for sure until the next billing cycle from the provider. Gotta love our healthcare system.

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After a recent routine medical procedure that included various entities over the course of a few weeks, the bills finally started arriving. Explanations of Benefits from our insurance company had prepared me for what was coming as the claims were clearly itemized by date of service, provider, and actual service. Normally it’s fairly easy, though cumbersome, to match bills to claims, but this particular medical group uses an accounting practice that makes that virtually impossible.

Due to insurance company processes, some claims are settled faster than others, so it is common to be billed out of service-date-sequence. Not an issue if you can match the bills to the claims. However, this company applies your payment to the oldest and lowest dollar amount open items on your account first, even if you have not yet received a bill for them.

We found this out only after I paid a bill via check that I enclosed with the payment coupon for that specific bill – which aligned with the insurance claim. A week later we received another round of bills including the one that I had just paid, but with a lower dollar amount listed. Confused, we called the billing office. The representative explained that even though I sent the check with the payment coupon and wrote the check number on that coupon, the company ignores that and automatically applies all payments as described above. WHAT?! I had to ask him to explain that three times and my wife had to restrain me from jumping through the phone.

He went on to tell us that the only way to get your payment applied to the invoice you intended to pay is to include a separate note stating specifically what charge the payment is to be applied to. Isn’t that what the payment coupon is?! For every other entity I have dealt with, that is exactly the purpose of the payment coupon, but not with this outfit. They are going to apply your payment to items you may not have been billed for yet and re-bill you for things you thought you already paid – with a different dollar amount if part of your payment was actually applied to that item. This makes it virtually impossible to match payments to claims so you can track what has been paid and what bills could still be coming.

I’ll give them the benefit of the doubt that this is just easier for their accounting system, and/or meant to drive patients to pay via credit or debit card, and not done intentionally to create the opportunity for patients to over-pay. It is certainly not a customer-focused process and that is the reason for this post. Let this serve as a warning to watch out for non-standard medical billing practices that make an already painful process even worse, and don’t hesitate to call the billing office if you have questions or suspect a billing error. It’s your health and your money, so make sure you take care of both.

www.RetiredandInspiredat55.com  04-21-2025