Practice operations · 2026-02-26 · 4 min
Common Medical Billing Mistakes
Six recurring billing mistakes in physician practices, from eligibility timing to write-offs that hide denials.
Checking coverage after the visit
Eligibility run after the claim denies is a research project. Eligibility run before the visit is a registration task. The 271 response will not promise payment, but it will catch an inactive plan while the patient is still available to present another card.
A card photo in a chart is not a check. Names, dependents, and plan years change. The transaction or a portal lookup has to be current.
Treating authorization as a claim field someone else filled
Procedures, imaging, and drugs often need a number, a date span, and a unit count. The claim field is the last place that number appears, not the first. If scheduling and billing do not share a status, the denial is scheduled in advance.
A referral and an authorization are not always the same document. Billing the referral number in the authorization field is a common, boring denial.
Coding from the favorite, not the note
Superbills drift toward a single E/M level and a single procedure. The note may support something else, or it may support less. Undercoding leaves allowed money unbilled. Overcoding creates refund exposure. The correction is a query, not a silent change and not a revenue target.
Copied templates make this worse. A long review of systems that was not performed does not raise a level. Reviewers read the assessment.
Posting and write-off habits
Applying a lump payment to the oldest claims, writing off every denial at posting, and sending a patient statement before adjudication are three ways to make the A/R untrustworthy. Contractual adjustments, patient responsibility, and true denials are different buckets.
None of these mistakes require a new product to see. They require a queue, a definition, and a person who is allowed to stop a claim. That is the work an assessment should look for.
A short audit you can run this month
Pull twenty recent claims and twenty recent write-offs. For each claim, note whether eligibility was checked before the visit, whether an authorization number was required and present, and whether the coded level matches the assessment in the note. For each write-off, note whether it was contractual, patient responsibility, or a denial closed without an appeal decision.
The sample is not a statistical study. It is large enough to show a habit. If more than a handful fail the same check, that check becomes the next change in registration, coding, or posting. Keep the sample inside the billing system. A public form is the wrong place for claim images. Repeat the same twenty-claim look after the change so the practice can see whether the habit actually moved.