Audit Cases

Audit of dialysis treatment 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. East Hartford, CT

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

High-Dollar Services:

  • Dialysis treatments (3): $66,433.25

Savings Summary:

  • Billed Charges: $66,433.25
  • ClaimDOC Allowed: $935.97
  • Plan Savings: $65,497.28
  • Reduction: 99%

2. Brooksville, FL

Five-day hospital stay for the treatment of stroke

  • CT Scans: $56,566.97
  • Pharmacy: $45,762.77
  • Room and Board: $26,563.50
  • MRIs: $22,735.36
  • Billed Charges: $211,201.52
  • ClaimDOC Allowed: $16,114.14
  • Plan Savings: $195,087.38
  • Reduction: 92%
High-Dollar Services: Savings Summary:

3. Concord, CA

Hospital outpatient services for the treatment of right humerus fracture with surgery

  • Operating Room: $31,505.00
  • Recovery Room: $10,947.00
  • Billed Charges: $53,568.90
  • ClaimDOC Allowed: $8,390.23
  • Plan Savings: $45,178.67
  • Reduction: 84%
High-Dollar Services: Savings Summary:

4. Hospital outpatient services for the treatment of secondary malignant bone cancer

Hospital outpatient services for the treatment of coronary heart disease

  • Radiation Treatments (10): $58,686.00
  • Billed Charges: $59,071.00
  • ClaimDOC Allowed: $19,460.93
  • Plan Savings: $48,062.05
  • Reduction: 81%
High-Dollar Services: Savings Summary:

5. Iowa City, IA

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

High-Dollar Services:

  • Operating Room: $44,000.00
  • Medical/Surgical Supplies: $11,311.75
  • Recovery Room: $10,163.00

Savings Summary:

  • Billed Charges: $84,908.65
  • ClaimDOC Allowed: $16,912.32
  • Plan Savings: $67,996.33
  • Reduction: 80%

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.