Audit Cases 1 min read

Audit of treatment of complications related to childbirth results in $85,068 plan savings

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. Pittsburgh, PA

Eight-day hospital stay for the treatment of complications related to childbirth

  • Laboratory Services: $22,754.50
  • Room and Board: $21,280.00
  • Anesthesia: $17,074.00
  • Pharmacy: $11,872.50
  • Billed Charges: $103,137.00
  • ClaimDOC Allowed: $18,068.92
  • Plan Savings: $85,068.08
  • Reduction: 82%
High-Dollar Services: Savings Summary:

2. New Braunfels, TX

Two-day hospital stay for the treatment of severe infection, pneumonia, and kidney failure

  • Respiratory Services: $24,988.00
  • Operating Room: $15,540.00
  • Room and Board: $15,480.00
  • Billed Charges: $82,309.00
  • ClaimDOC Allowed: $17,828.51
  • Plan Savings: $64,480.49
  • Reduction: 78%
High-Dollar Services: Savings Summary:

3. Huntington, WV

Hospital outpatient services for treatment of spinal stenosis and related surgery

  • Operating Room: $31,559.00
  • Implants: $17,339.00
  • Anesthesia: $6,692.00
  • Billed Charges: $60,784.61
  • ClaimDOC Allowed: $16,104.63
  • Plan Savings: $44,679.98
  • Reduction: 74%
High-Dollar Services: Savings Summary:

4. Boston, MA

Twenty-one-day hospital stay for the treatment of heart vessel tear and related surgery

  • Operating Room: $180,472.00
  • Room and Board: $145,690.00
  • Laboratory Services: $55,134.00
  • Medical/Surgical Supplies: $15,335.38
  • Anesthesia: $12,988.00
  • Blood Processing/Storage: $13,834.00
  • Billed Charges: $479,955.51
  • ClaimDOC Allowed: $131,630.34
  • Plan Savings: $348,325.17
  • Reduction: 73%
High-Dollar Services: Savings Summary:

5. Knoxville, TN

Three-day hospital stay for the treatment of Diabetes, osteomyelitis and kidney disease

  • Medical/Surgical Supplies: $31,476.06
  • Cardiac Cath Lab: $29,480.00
  • Room and Board: $14,430.00
  • Billed Charges: $54,118.85
  • ClaimDOC Allowed: $17,063.14
  • Plan Savings: $37,055.71
  • Reduction: 68%
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.