Audit Cases

96% bill reduction after audit of physician services

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. Bridgeport, CT

Physician services for breast reconstruction surgery related to malignant neoplasm of lt. breast

  • Physician Services $61,500
  • Billed Charges: $61,500
  • ClaimDOC Allowed: $1,879.31
  • Plan Savings: $59,620.69
  • Reduction: 96%
High-Dollar Services: Savings Summary:

2. Brooksville, FL

Hospital outpatient services for the treatment of varicose veins of left lower extremity

  • Operating Room: $46,981.50
  • Radiology: $17,447.25
  • Anesthesia: $9,456.50
  • Billed Charges: $90,215.89
  • ClaimDOC Allowed: $5,772.61
  • Plan Savings: $84,443.28
  • Reduction: 93%
High-Dollar Services: Savings Summary:

3. Norwich, CT

Ambulatory Surgery services for left breast reconstruction due to breast cancer

  • Surgery: $50,600
  • Billed Charges: $50,600
  • ClaimDOC Allowed: $4,422.53
  • Plan Savings: $46,177.47
  • Reduction: 91%
High-Dollar Services: Savings Summary:

4. Sylacauga, AL

Air ambulance services for the transport of patient with sepsis and respiratory failure

  • Air Ambulance Transport: $50,836.60
  • Air Ambulance Mileage: $10,577.82
  • Billed Charges: $61,414.42
  • ClaimDOC Allowed: $5,380.56
  • Plan Savings: $56,033.86
  • Reduction: 91%
High-Dollar Services: Savings Summary:

5. Stockton, CA

Twenty-two-day hospital stay for the treatment of sepsis due to E. Coli

High-Dollar Services:

  • Room and Board: $163,988
  • Laboratory: $65,566
  • Respiratory: $45,981
  • CT Scan: $14,466

Savings Summary:

  • Billed Charges: $340,130
  • ClaimDOC Allowed: $32,720.64
  • Plan Savings: $307,409.36
  • Reduction: 90%

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.