Audit Cases

Audit of two-day hospital stay results in 92% bill 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. Turlock, CA

Two-day hospital stay for the treatment of a stroke

  • CT Scans: $34,038
  • Room and Board: $24,112
  • Emergency Room: $14,725
  • Laboratory: $11,295
  • MRI: $9,885
  • Echocardiography: $8,307
  • Billed Charges: $112,810
  • ClaimDOC Allowed: $8,560.85
  • Plan Savings: $104,249.15
  • Reduction: 92%
High-Dollar Services: Savings Summary:

2. Salem, VA

Hospital outpatient services for breast reduction surgery

  • Operating Room $59,269
  • Medical/Surgical Supplies $9,403
  • Recovery Room $8,023
  • Billed Charges: $97,176.86
  • ClaimDOC Allowed: $8,806.11
  • Plan Savings: $88,370.75
  • Reduction: 90%
High-Dollar Services: Savings Summary:

3. Clarksville, TN

Four-day hospital stay for the treatment of heart attack

  • Cardiac Cath Lab: $142,285.07
  • Room and Board: $21,247.20
  • Implants: $19,209.65
  • Billed Charges: $201,423.07
  • ClaimDOC Allowed: $18,508.85
  • Plan Savings: $182,914.22
  • Reduction: 90%
High-Dollar Services: Savings Summary:

4. Deltona, FL

Hospital outpatient services for the treatment of appendicitis and related surgery

  • Operating Room: $20,558
  • CT of abdomen/pelvis: $6,955
  • Medical/Surgical Supplies: $5,105
  • Billed Charges: $51,345
  • ClaimDOC Allowed: $9,947.27
  • Plan Savings: $41,397.73
  • Reduction: 80%
High-Dollar Services: Savings Summary:

5. Denville, NJ

Three-day hospital stay for the treatment of sepsis and kidney failure

High-Dollar Services:

  • Room and Board: $30,000
  • Pharmacy: $27,742.89
  • Laboratory: $13,121.28

Savings Summary:

  • Billed Charges: $87,805.97
  • ClaimDOC Allowed: $21,058.04
  • Plan Savings: $66,747.93
  • Reduction: 76%

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.