Audit Cases 1 min read

80% claim reduction after audit of myasthenia gravis 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 results bi-monthly. See the savings below and know that together we can make healthcare affordable.

1. Urbana, IL

Nine-day hospital stay for the treatment of myasthenia gravis

  • Pharmacy: $47,967.00
  • Room and Board: $32,130.00
  • Treatment/Observation Room: $27,600.00
  • Billed Charges: $135,372.52
  • ClaimDOC Allowed: $26,633.73
  • Plan Savings: $108,738.79
  • Reduction: 80%
High-Dollar Services: Savings Summary:

2. Rogers, AR

Three-day hospital stay for the treatment of heart attack

  • Cardiac Cath Lab: $34,109.00
  • Room and Board: $11,679.00
  • Billed Charges: $62,940.37
  • ClaimDOC Allowed: $16,543.06
  • Plan Savings: $46,397.31
  • Reduction: 74%
High-Dollar Services: Savings Summary:

3. San Francisco, CA

One-day hospital stay for the treatment of adolescent scoliosis and related surgery

  • Operating Room: $39,527.00
  • Medical/Surgical Supplies: $23,498.00
  • Room and Board: $17,005.00
  • Billed Charges: $98,896.30
  • ClaimDOC Allowed: $32,213.30
  • Plan Savings: $66,683.00
  • Reduction: 67%
High-Dollar Services: Savings Summary:

4. Madison, WI

Three-day hospital stay for the treatment of lung cancer

  • Operating Room: $35,375.00
  • Medical/Surgical Supplies: $13,693.79
  • Room and Board: $7,290.00
  • Billed Charges: $83,081.65
  • ClaimDOC Allowed: $27,313.04
  • Plan Savings: $55,768.61
  • Reduction: 67%
High-Dollar Services: Savings Summary:

5. Hartford, CT

Five-day hospital stay for the treatment of stroke

  • Room and Board: $22,400.00
  • Cardiac Cath Lab: $13,567.00
  • CT Scans: $7,957.00
  • Billed Charges: $72,818.07
  • ClaimDOC Allowed: $32,429.98
  • Plan Savings: $40,388.09
  • Reduction: 55%
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.