Audit Cases

96% bill reduction after audit of treatment of 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 clinic dialysis services for the treatment of end-stage renal disease

High-Dollar Services:

  • Dialysis Treatments (13): $136,343.66

Savings Summary:

  • Billed Charges: $136,343.66
  • ClaimDOC Allowed: $4,878.44
  • Plan Savings: $131,465.22
  • Reduction: 96%

2. Trumbull, CT

ASC services for the treatment of right shoulder strain and related surgery

  • ASC – Surgery: $67,395
  • Billed Charges: $67,395
  • ClaimDOC Allowed: $5,604.73
  • Plan Savings: $61,790.27
  • Reduction: 92%
High-Dollar Services: Savings Summary:

3. Las Vegas, NV

Hospital outpatient services for the treatment of vaginal septum and related surgery

  • Operating Room: $28,810
  • Anesthesia: $11,454
  • Billed Charges: $52,859
  • ClaimDOC Allowed: $6,097.50
  • Plan Savings: $46,761.50
  • Reduction: 88%
High-Dollar Services: Savings Summary:

4. Huntington, WV

One-day hospital stay for the treatment of heart attack

  • Cardiac Cath Lab: $75,400
  • Medical/Surgical Supplies: $44,855
  • Billed Charges: $127,712.35
  • ClaimDOC Allowed: $16,166.31
  • Plan Savings: $111,546.04
  • Reduction: 87%
High-Dollar Services: Savings Summary:

5. Sanford, FL

Nine-day hospital stay for the treatment of colon disease, surgery and other medical complications

High-Dollar Services:

  • Anesthesia: $21,025
    Room and Board: $13,852.25

Savings Summary:

  • Billed Charges: $103,753.56
  • ClaimDOC Allowed: $16,110.44
  • Plan Savings: $87,643.12
  • Reduction: 84%

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.