Audit Cases

99% claim reduction after audit of end-stage renal disease 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. Dunbar, WV

Clinic dialysis for the treatment of end-stage renal disease

  • Three Dialysis Treatments: $22,888.26
  • Pharmacy: $12,709.50
  • Billed Charges: $56,767.84
  • ClaimDOC Allowed: $830.79
  • Plan Savings: $55,937.05
  • Reduction: 99%
High-Dollar Services: Savings Summary:

2. Arlington, TX

One-day hospital stay for the treatment of intervertebral disc disorder

  • Cardiology Services: $59,806.54
  • Medical/Surgical Supplies: $303,584.28
  • Operating Room: $54,382.72
  • Billed Charges: $390,789.00
  • ClaimDOC Allowed: $42,048.68
  • Plan Savings: $348,740.32
  • Reduction: 89%
High-Dollar Services: Savings Summary:

3. Orlando, FL

Six-day hospital stay for the treatment of Crohn’s Disease

  • Medical/Surgical Supplies: $19,797.64
  • Room and Board: $17,760.00
  • MRI: $12,533.00
  • Pharmacy: $12,521.04
  • Billed Charges: $97,282.68
  • ClaimDOC Allowed: $15,121.30
  • Plan Savings: $82,161.38
  • Reduction: 84%
High-Dollar Services: Savings Summary:

4. Bronx, NY

Four-day hospital stay for the treatment of heart attack

  • Room and Board: $60,208.00
  • Cardiac Cath Lab: $24,387.00
  • Room and Board: $153,650.00
  • Billed Charges: $117,229.09
  • ClaimDOC Allowed: $25,608.86
  • Plan Savings: $91,620.23
  • Reduction: 78%
High-Dollar Services: Savings Summary:

5. Kingsport, TN

Hospital outpatient services for the treatment of congestive heart failure

  • Cardiac Cath Lab: $47,394.00
  • Medical/Surgical Supplies: $29,571.12
  • Billed Charges: $143,202.98
  • ClaimDOC Allowed: $36,208.43
  • Plan Savings: $106,994.55
  • Reduction: 75%
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.