Audit Cases

Audit of outpatient services for the treatment of varicose veins results in 93% 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. Brooksville, FL

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

High-Dollar Services:

  • Operating Room: $46,981.50
  • Radiology: $17,447.25
  • Anesthesia: $9,456.50

Savings Summary:

  • Billed Charges: $90,215.89
  • ClaimDOC Allowed: $5,772.61
  • Plan Savings: $84,443.28
  • Reduction: 93%

2. 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:

3. Stockton, CA

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

  • Room and Board: $163,988
  • Laboratory: $65,566
  • Respiratory: $45,981
  • CT Scan: $14,466
  • Billed Charges: $340,130
  • ClaimDOC Allowed: $32,720.64
  • Plan Savings: $307,409.36
  • Reduction: 90%
High-Dollar Services: Savings Summary:

4. Key West, FL

Hospital outpatient services for the treatment of appendicitis and surgery

  • Operating Room: $36,793.25
  • Observation Care: $15,365
  • CT Scan: $9,369
  • Billed Charges: $103,316.39
  • ClaimDOC Allowed: $10,394.45
  • Plan Savings: $92,921.94
  • Reduction: 89%
High-Dollar Services: Savings Summary:

5. Paducah, KY

Hospital outpatient services for the treatment of kidney stone

High-Dollar Services:

  • Lithotripsy: $57,108
  • Operating Room: $17,878

Savings Summary:

  • Billed Charges: $81,042.19
  • ClaimDOC Allowed: $13,012.95
  • Plan Savings: $68,029.24
  • Reduction: 83%

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.