Each province’s health insurance billing system is different, but they all have one important thing in common: a gigantic, complex raft of billing codes which are seemingly designed to haunt you in your sleep. With thousands of codes, and with frequent revisions to the fee schedule, it’s difficult to imagine a bureaucratic system (besides perhaps the Canada Revenue Agency’s) more challenging to decipher than your province’s billing agency.

Not that it’s your fault. Physicians aren’t being educated on the issue, says Carmen Medeiros of the management and collection firm Ontario Medical Billing Services Inc. “They graduate with their specialty in hand, they get their billing number, and [the schools] go, ‘Here you go, go to work.’” But doctors aren’t prepared for the confusing world of medical billing. “They don’t know anything,” says Ms. Medeiros. “They’re green as grass.” The result? All too often it’s money lost because claims are rejected.

Parkhurst Exchange asked two government agencies — British Columbia’s Medical Services Commission and the Ontario Health Insurance Plan — to spill the beans on the 5 types of billing errors they see most frequently.

1. Missing or mismatched information Coming in as the number one type of error in both provinces, some of the most common simple mistakes include wrongly identifying the hospital or lab where a procedure was done; specialists neglecting to identify the referring physician; and getting Ontario patients’ health card version codes wrong.

2. Multiple claims despite multiple-visit codes Certain billing codes encompass more than one procedure — some surgical and obstetrical codes, for instance, include provisions for preparatory or follow-up visits — yet physicians often forget that’s the case and end up billing for the prep or follow-ups separately.

3. Duplicate claims It’s not entirely surprising that some claims could be submitted more than once by mistake, given how long processing takes. But you can’t get paid twice for the same claim. Sorry.

4. Partial-claim percentages miscalculated Some claims are straightforward. Office consult. Pap smear. But others may require a bit of arithmetic. Surgeons can run into this problem if they do several things while a patient is on the OR table, depending on how many incisions are made, how many applications of anesthetic the surgery requires, how many surgeons are working, etc. Suffice it to say, it’s not simple.

5. Wrong specialty Some billing codes are only for use by certain specialists. Check the fee schedule to make sure you’re up to date.