Study: Older Americans Struggling With Erroneous Medical Debt

by  Find-A-Code™
Sep 20th, 2023

Medical billing has not been an easy task since the introduction of health insurance decades ago. As time has gone by though, both medical billing and payments have become more complicated. So it's no wonder that older Americans are now struggling with erroneous medical debt brought on by inaccurate medical billing.

As a medical billing or coding specialist, you know all too well how complicated the system is. It is complicated enough when dealing with private payers. But when Medicare and Medicaid get involved, complications easily jump to the next level.

A recent study conducted by the Consumer Financial Protection Bureau (CFPB) tells the whole story. According to their report, millions of older Americans who qualify as dual Medicare and Medicaid beneficiaries have been billed erroneously. Many are paying bills they don't legitimately owe, making it harder for them to make ends meet.

Millions Have Unpaid Medical Bills

The CFPB report indicates that nearly 4 million adults in the 65+ age bracket reported unpaid medical bills in 2020. Furthermore, 98% of those adults had medical insurance at the time. Some 70% were covered by at least two medical insurances – be they public, private, or combination of both.

Translated into real dollars, the total value of unpaid medical bills among seniors was in excess of $53 billion in 2020. The total amount just a year earlier was closer to $45 billion. That represents a 20% increase from 2019 to 2020.

It's Not Clear Why

Excess medical debt among seniors is partially caused by erroneous billing. Unfortunately, the CFPB report is not clear as to why such erroneous billing is taking place. Is it intentional among billers? Is it the result of errors that are too difficult to catch because of an overly complicated system?

In all likelihood, erroneous billing is a combination of multiple factors. There are undoubtedly those unscrupulous billers willing to utilize any means necessary to get their hands on every single dollar. Federal prosecutions of such billers are evidence of their practices.

On the other hand, medical billing is one of the most complex systems in the world. How ironic that medical billing codes were first developed to streamline billing so as to make it more efficient and accurate. What started out as a better system has become a hungry behemoth that can never be satisfied. The bigger it grows, the more room there is for errors.

Be a Student of the System

As a medical biller or coder, we assume you do not want to contribute to the problem of erroneous billing among older Americans. You have little to no control over how your employer does business. However, you do have control over your own work. We encourage you to be a student of the system.

You already make it your business to stay abreast of medical billing codes. You work hard to improve your accuracy and efficiency. You check out every new guide and every update furnished by the AMA and CMS. But don't stop there. Take every opportunity you have to become a better biller or coder.

We are doing our part by maintaining an up-to-date database of the medical billing codes you need to do your job. We strive to make looking up codes as easy as possible, knowing that you don't want our website to be a hindrance to your work.

Older Americans are struggling with medical debt. Some of their struggles are attributable to erroneous billing, especially among patients dual enrolled in Medicare and Medicaid. It is a problem that we have to get a handle on sooner rather than later.