Audit Cases

90% claim reduction after an audit of treatment of ovarian cyst

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. Salem, VA

Hospital outpatient services for the treatment of enlarged ovarian cyst

  • Medical/Surgical Supplies: $28,653.00
  • Operating Room: $26,930.00
  • Billed Charges: $74,391.00
  • ClaimDOC Allowed: $7,423.77
  • Plan Savings: $66,967.23
  • Reduction: 90%
High-Dollar Services: Savings Summary:

2. Okeechobee, FL

Five-day hospital stay for the treatment of diverticulitis of the intestine

  • Operating Room: $31,916.00
  • Medical/Surgical Supplies: $24,704.38
  • Room and Board: $13,618.00
  • Pharmacy: $13,606.00
  • Billed Charges: $107,735.68
  • ClaimDOC Allowed: $15,814.81
  • Plan Savings: $91,920.87
  • Reduction: 85%
High-Dollar Services: Savings Summary:

3. Orlando, FL

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

  • Medical/Surgical Supplies: $34,596.68
  • Room and Board: $26,736.00
  • Operating Room: $18,582.00
  • CT Scan: $12,201.00
  • Billed Charges: $115,928.73
  • ClaimDOC Allowed: $21,355.03
  • Plan Savings: $94,573.70
  • Reduction: 82%
High-Dollar Services: Savings Summary:

4. Villa Rica, CA

Hospital outpatient services for the elective hysterectomy surgery

  • Pharmacy: $29,872.55
  • Operating Room: $24,141.00
  • Billed Charges: $61,211.92
  • ClaimDOC Allowed: $13,480.83
  • Plan Savings: $47,731.09
  • Reduction: 78%
High-Dollar Services: Savings Summary:

5. Hartford, CT

Eight-day hospital stay for the treatment of herpes viral disease

  • Room and Board: $42,174.00
  • CT Scans: $14,232.50
  • Laboratory: $8,561.88
  • Billed Charges: $86,897.98
  • ClaimDOC Allowed: $27,280.45
  • Plan Savings: $59,617.53
  • 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.