Audit Cases

Audit of clinic dialysis treatment for end stage renal disease results in 99% 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. Hartford, CT

Clinic dialysis treatments (3) for end-stage renal disease 

High-Dollar Services:

  • Clinic Dialysis Treatments (3): $22,888.26

Savings Summary:

  • Billed Charges: $65,085.07
  • ClaimDOC Allowed: $623.32
  • Plan Savings: $64,461.75
  • Reduction: 99%

2. Bradenton, FL

Hospital outpatient services for the treatment of osteoarthritis, right foot, and related surgery

  • Implants: $49,796
  • Operating Room: $47,209
  • Anesthesia: $19,462
  • Billed Charges: $131,167
  • ClaimDOC Allowed: $14,668.52
  • Plan Savings: $116,498.48
  • Reduction: 89%
High-Dollar Services: Savings Summary:

3. Lima, OH

One-day hospital stay for the treatment of osteoarthritis of the left hip and related surgery

  • Implants: $48,670.92
  • Operating Room: $17,515.59
  • Billed Charges: $82,538.07
  • ClaimDOC Allowed: $14,056.90
  • Plan Savings: $68,481.17
  • Reduction: 83%
High-Dollar Services: Savings Summary:

4. Mineola, NY

One-day hospital stay for the treatment of pulmonary nodule and related surgery

  • Operating Room: $68,136.33
  • Implants: $27,699.13
  • Laboratory: $23,705.18
  • Medical/Surgical Supplies: $14,028.04
  • Billed Charges: $153,656.36
  • ClaimDOC Allowed: $28,188.64
  • Plan Savings: $125,467.72
  • Reduction: 82%
High-Dollar Services: Savings Summary:

5. Mason City, IA 

Six-day hospital stay for the treatment of coronary artery disease and related surgery

High-Dollar Services:

  • Operating Room: $121,282
  • Anesthesia: $48,718
  • Room and Board: $27,652
  • Recovery Room: $23,655
  • Laboratory: $17,388.50

Savings Summary:

  • Billed Charges: $271,503.40
  • ClaimDOC Allowed: $72,581.58
  • Plan Savings: $198,921.82
  • Reduction: 73%

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.