Medicare Reductions from a Lame-Duck Congress? Not likely!
On November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) released its final rule cutting Medicare payments by 4.5% for physicians (including physicians,…
Resources
Substantial Disparities Among Charges for CT Scans – What is a Reasonable Fee?
Background ClaimDOC’s comprehensive line-by-line review of claims uncovers errors that basic claim repricing and auto-adjudication does not catch, leading to greater savings for health plans…
99% bill reduction after audit of ASC services for treatment of osteoarthritis of the spine
Comprehensive line-by-line claim auditing by healthcare professionals is used to uncover errors typically not caught. ClaimDOC publishes a sample of five recent client savings audit…
Audit of outpatient services for treatment of rib fractures results in 96% bill reduction
Comprehensive line-by-line claim auditing by healthcare professionals is used to uncover errors typically not caught. ClaimDOC publishes a sample of five recent client savings audit…
The Art of Persuasion – RBP is Bad for Members
Human Resources Teams are tasked with developing benefit solutions that meet many needs. They recruit new employees with competitive offerings and retain employees by meeting…
Audit Reveals Varied Costs for Spinal Surgery
Background ClaimDOC’s comprehensive line-by-line review of claims uncovers errors that basic claim repricing and auto-adjudication does not catch, leading to greater savings for health plans…
86% bill reduction after audit of hospital outpatient services for spinal instabilities treatment
Comprehensive line-by-line claim auditing by healthcare professionals is used to uncover errors typically not caught. ClaimDOC publishes a sample of five recent client savings audit…
Audit of six-day hospital stay for the treatment of pelvic inflammatory disease results in a 92% bill reduction
Comprehensive line-by-line claim auditing by healthcare professionals is used to uncover errors typically not caught. ClaimDOC publishes a sample of five recent client savings audit…
Chicken Little and PHCS
I was asked to write an article expressing our position on the recent news that PHCS would only be allowed alongside HST on RBP business.
Claim Audit Reveals 720 Minutes of Overbilled Anesthesia Time
Background ClaimDOC’s comprehensive line-by-line review of claims uncovers errors that basic claim repricing and auto-adjudication does not catch, leading to greater savings for health plans…