Audit Cases

Audit of dialysis treatment results in a 99% claim 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. East Hartford, CT

Outpatient clinic services for three (3) dialysis treatment

  • Dialysis Treatments (3): $71,092.75
  • Billed Charges: $71,092.75
  • ClaimDOC Allowed: $937.95
  • Plan Savings: $70,154.80
  • Reduction: 99%
High-Dollar Services: Savings Summary:

2. New Albany, OH

Ambulatory surgical center services for the treatment of osteoarthritis of the left knee

  • ASC Surgery: $75,000.00
  • Implant: $7,250.00
  • Billed Charges: $83,337.00
  • ClaimDOC Allowed: $10,667.84
  • Plan Savings: $72,669.16
  • Reduction: 87%
High-Dollar Services: Savings Summary:

3. Sanford, FL

Eleven-day hospital stay for the treatment of severe infection, heart attack and Covid-19

  • Laboratory: $25,737.75
  • Pharmacy: $20,586.26
  • Respiratory: $17,931.50
  • Billed Charges: $145,673.09
  • ClaimDOC Allowed: $28,056.20
  • Plan Savings: $117,616.89
  • Reduction: 81%
High-Dollar Services: Savings Summary:

4. Boston, MA

Five-day hospital stay for the treatment of lung cancer

  • Operating Room: $90,399.00
  • Room and Board: $38,205.00
  • Anesthesia: $10,314.00
  • Billed Charges: $160,744.43
  • ClaimDOC Allowed: $34,673.62
  • Plan Savings: $126,070.81
  • Reduction: 78%
High-Dollar Services: Savings Summary:

5. Peoria, IL

Hospital outpatient services for the treatment of osteoarthritis of the left hip

  • Implant: $27,346.00
  • Operating Room: $14,138.00
  • Billed Charges: $61,756.35
  • ClaimDOC Allowed: $14,129.93
  • Plan Savings: $47,626.42
  • Reduction: 77%
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.