March 13, 2004
Top 10 Medicare Billing Errors
- Filing a duplicate claim.
- Service billed was not medically necessary.
- The service billed is an unbundled service.
- Missing or incorrect modifier.
- Incomplete or incorrect demographic information on claim form – beneficiary name, health insurance claim number, or sex.
- Service not covered under the Medicare program.
- Medicare is the secondary payer.
- Information about where service was rendered is incomplete, missing, or invalid.
- Service billed is considered a routine screening procedure performed in conjunction with a routine exam.
- Physician UPIN number and provider name either invalid or missing.
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