Audit Cases 1 min read

$69,894 in plan savings after audit of six day hospital stay

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 results bi-monthly. See the savings below and know that together we can make healthcare affordable.

1. Hermitage, TN

Six-day hospital stay for intestinal abscess

  • CT Body Scans: $34,809.81
  • Pharmacy: $21,798.45
  • Room & Board: $12,246.00
  • Billed Charges: $79,247.79
  • ClaimDOC Allowed: $9,353.09
  • Plan Savings: $69,894.70
  • Reduction: 88%
High-Dollar Services: Savings Summary:

2. Mountain View, CA

Seven-day hospital stay due to elective back surgery

  • Medical/Surgical Supplies: $401,294.86
  • Operating Room: $121,986.23
  • Room & Board: $55,650.00
  • Anesthesia: $17,818.23
  • Billed Charges: $631,087.06
  • ClaimDOC Allowed: $108,341.70
  • Plan Savings: $522,745.36
  • Reduction: 83%
High-Dollar Services: Savings Summary:

3. San Antonio, TX

Three-day hospital stay for bladder cancer surgery

  • Operating Room: $27,546.08
  • Medical/Surgical Supplies: $16,020.00
  • Anesthesia: $9,984.68
  • Billed Charges: $91,798.64
  • ClaimDOC Allowed: $22,122.56
  • Plan Savings: $69,676.08
  • Reduction: 76%
High-Dollar Services: Savings Summary:

4. Santa Ana, CA

Nineteen-day hospital stay for brain hemorrhage

  • Pharmacy: $59,799.90
  • CT Head Scans: $30,497.85
  • Respiratory: $27,136.00
  • Emergency Room: $14,799.57
  • Billed Charges: $295,016.26
  • ClaimDOC Allowed: $71,842.40
  • Plan Savings: $223,173.86
  • Reduction: 76%
High-Dollar Services: Savings Summary:

5. Chillicothe, OH

One-day hospital stay for pelvic surgery

  • Operating Room: $42,617.67
  • Anesthesia: $5,920.80
  • Room & Board: $3,360.00
  • Billed Charges: $55,863.93
  • ClaimDOC Allowed: $15,412.61
  • Plan Savings: $40,451.32
  • Reduction: 72%
High-Dollar Services: Savings Summary:

Disclaimer – The analysis of any medical billing or coding is dependent on numerous facts, regulations, payer policies, and codes, as well as the controlling plan description. The information contained herein is intended to provide a real-life example of opportunities for savings through ClaimDOC services but is not intended to provide medical, legal, or financial advice.