Audit Cases

97% bill reduction after audit of treatment for end-stage renal disease

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. Hazel Park, MI

Outpatient dialysis services for the treatment of end-stage renal disease

High-Dollar Services:

  • Dialysis Treatments (10): $118,103.27

Savings Summary:

  • Billed Charges: $118,103.27
  • ClaimDOC Allowed: $3,709.95
  • Plan Savings: $114,393.32
  • Reduction: 97%

2. Plant City, FL

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

  • Operating Room: $41,148.81
  • Implants: $6,201.44
  • Billed Charges: $66,834.10
  • ClaimDOC Allowed: $6,375.31
  • Plan Savings: $60,458.79
  • Reduction: 90%
High-Dollar Services: Savings Summary:

3. San Marcos, TX

Hospital outpatient services for the treatment of coronary heart disease

  • Cath Lab: $36,721
  • Implant: $17,551.14
  • Billed Charges: $81,104.85
  • ClaimDOC Allowed: $14,662.01
  • Plan Savings: $66,442.84
  • Reduction: 82%
High-Dollar Services: Savings Summary:

4. Ft. Wayne, IN

Hospital outpatient services for the treatment of coronary heart disease

  • Cath Lab: $57,763
  • Implants: $34,862
  • Billed Charges: $100,303.40
  • ClaimDOC Allowed: $19,460.93
  • Plan Savings: $80,842.47
  • Reduction: 81%
High-Dollar Services: Savings Summary:

5. Iowa City, IA

Four-day hospital stay for the treatment of bone cancer right and left legs and surgery

High-Dollar Services:

  • Implants: $99,001
  • Operating Room: $43,612
  • Room and Board: $10,620

Savings Summary:

  • Billed Charges: $179,788.39
  • ClaimDOC Allowed: $48,979.47
  • Plan Savings: $130,808.92
  • 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.