Audit Cases 1 min read

Audit of three-day hospital stay results in 82% 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 results bi-monthly. See the savings below and know that together we can make healthcare affordable.

1. Ocala, FL

Three-day hospital stay for treatment of cancer of the uterus and related surgery

  • Operating Room: $36,211.00
  • Anesthesia: $11,649.00
  • Recovery Room: $6,719.00
  • Billed Charges: $71,991.01
  • ClaimDOC Allowed: $13,182.69
  • Plan Savings: $58,808.32
  • Reduction: 82%
High-Dollar Services: Savings Summary:

2. Atlanta, GA

Nineteen-day hospital stay for treatment of severe infection, other complications and COVID-19

  • Pharmacy: $149,547.97
  • Room and Board: $129,884.00
  • Laboratory: $120,522.00
  • Respiratory: $45,832.00
  • Billed Charges: $508,810.97
  • ClaimDOC Allowed: $129,605.45
  • Plan Savings: $379,205.52
  • Reduction: 75%
High-Dollar Services: Savings Summary:

3. Knoxville, TN

Six-day hospital stay for treatment of heart attack

  • Operating Room: $55,313.00
  • Medical/Surgical Supplies: $13,879.92
  • Room and Board: $11,585.00
  • Billed Charges: $108,766.98
  • ClaimDOC Allowed: $28,714.92
  • Plan Savings: $80,052.06
  • Reduction: 74%
High-Dollar Services: Savings Summary:

4. Peoria, IL

Hospital outpatient stay for treatment of osteoporosis of left hip and hip replacement surgery

  • Implant: $28,552.00
  • Operating Room: $22,892.00
  • Recovery Room: $7,636.00
  • Billed Charges: $67,673.09
  • ClaimDOC Allowed: $18,949.01
  • Plan Savings: $48,724.08
  • Reduction: 72%
High-Dollar Services: Savings Summary:

5. Long Island, NY

Hospital outpatient stay for treatment of Crohn’s Disease and medication infusion

  • Operating Room: $36,674.00
  • Room and Board: $19,840.00
  • Pharmacy: $50,090.00
  • Billed Charges: $53,292.75
  • ClaimDOC Allowed: $16,485.24
  • Plan Savings: $36,807.51
  • Reduction: 69%
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.