Audit Cases

90% bill reduction after audit of hospital outpatient services for uterine fibroids treatment

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. Blacksburg, VA

Hospital outpatient services for the treatment of uterine fibroids

  • Operating Room: $55,865
  • Medical/Surgical Supplies: $25,692
  • Anesthesia: $8,868
  • Billed Charges: $101,918
  • ClaimDOC Allowed: $10,189.91
  • Plan Savings: $91,728.09
  • Reduction: 90%

2. New Albany, OH

Ambulatory surgery center services for the treatment of right knee osteoarthritis

  • Surgery: $97,786.30
  • Billed Charges: $97,786.30
  • ClaimDOC Allowed: $10,864.64
  • Plan Savings: $86,921.66
  • Reduction: 88%
High-Dollar Services: Savings Summary:

3. Fort Lauderdale, FL

Three-day hospital stay for the treatment of alcoholic cirrhosis of the liver

  • Laboratory: $23,978
  • CT Scan: $12,972
  • Cardiology: $9,465
  • Billed Charges: $73,554
  • ClaimDOC Allowed: $9,183.16
  • Plan Savings: $64,370.84
  • Reduction: 87%
High-Dollar Services: Savings Summary:

4. San Antonio, TX

One-day hospital stay for the treatment of osteoarthritis of right hip

  • Implants: $50,820.81
  • Operating Room: $49,439
  • Billed Charges: $127,422.21
  • ClaimDOC Allowed: $16,406.48
  • Plan Savings: $111,015.73
  • Reduction: 87%
High-Dollar Services: Savings Summary:

5. Stockton, CA

Seventeen-day hospital stay for the treatment of sepsis

High-Dollar Services:

  • Room and Board: $126,718
  • Laboratory: $55,797
  • Pharmacy: $17,805

Savings Summary:

  • Billed Charges: $233,819
  • ClaimDOC Allowed: $33,523.44
  • Plan Savings: $200,295.56
  • Reduction: 85%

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.