In Billing
- Incorrect data entry
- Incorrect insurance address
- Billing for Expired/Terminated policy
- Incorrect provider
- Wrong DOS and place of service
- Claims without patient’s DOB , SSN & Insurance ID
- Referral not attached
- Provider’s Tax ID missing
- Supporting documents for specific services missing
- Incorrect modifiers
In Coding
- Incorrect data entry
- Wrong codes assigned
- Truncated diagnosis
- Unlimited services
- Non-LMRP codes for Medicare patients
- Codes don’t match with the sex
- ICD codes incompatible with CPT codes
- Old codes usage (that don’t exist)
- Unbundled codes
- Incorrect modifier