Audit Cases

Audit of four-day hospital stay results in 87% 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. Stockton, CA

Four-day hospital stay for the treatment of osteomyelitis of the low back

  • Room and Board: $29,816.00
  • MRI – Spinal Cord: $26,067.00
  • Billed Charges: $86,652.13
  • ClaimDOC Allowed: $11,320.34
  • Plan Savings: $75,331.79
  • Reduction: 87%
High-Dollar Services: Savings Summary:

2. Gainesville, FL

Eight-day hospital stay for the treatment of COVID-19 and pneumonia

  • Pharmacy: $29,649.75
  • Room and Board: $21,990.00
  • Laboratory Services: $21,261.00
  • CT Scan Head: $10,426.00
  • Billed Charges: $100,896.25
  • ClaimDOC Allowed: $19,245.09
  • Plan Savings: $81,651.16
  • Reduction: 81%
High-Dollar Services: Savings Summary:

3. San Francisco, CA

Hospital outpatient services for the treatment of prostate cancer

  • Operating Room: $50,207.00
  • Anesthesia: $12,150.00
  • Observation: $10,573.00
  • Billed Charges: $108,923.35
  • ClaimDOC Allowed: $22,176.78
  • Plan Savings: $86,746.57
  • Reduction: 80%
High-Dollar Services: Savings Summary:

4. Waterbury, CT

Fourteen-day hospital stay for the treatment of stomach cancer

  • Room and Board: $70,927.39
  • Operating Room: $40,216.00
  • Pharmacy: $33,022.84
  • Medical/Surgical Supplies: $23,321.26
  • Radiology: $20,144.70
  • Billed Charges: $282,546.99
  • ClaimDOC Allowed: $61,112.94
  • Plan Savings: $221,434.05
  • Reduction: 78%
High-Dollar Services: Savings Summary:

5. Pinehurst, NC

Ten-day hospital stay for the treatment of aneurysm of artery in the lower extremity

  • Operating Room: $25,085.50
  • Room and Board: $18,540.00
  • Laboratory Services: $14,398.25
  • Billed Charges: $103,906.17
  • ClaimDOC Allowed: $43,646.69
  • Plan Savings: $60,259.48
  • Reduction: 58%
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.