Audit Cases

Audit of sepsis and tachycardia treatments results in 91% 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. New Port Richey, FL

Five-day hospital stay for the treatment of sepsis and tachycardia

High-Dollar Services:

  • CT Scans: $52,766.40
  • Room and Board: $16,410
  • Ultrasounds: $13,305.46

Savings Summary:

  • Billed Charges: $115,695.62
  • ClaimDOC Allowed: $10,110.11
  • Plan Savings: $105,585.51
  • Reduction: 91%

2. Lufkin, TX

Hospital outpatient services for the treatment of benign tumor of uterus and related surgery

  • Operating Room: $60,684.42
  • Recovery Room: $10,097.51
  • Billed Charges: $80,733.28
  • ClaimDOC Allowed: $10,746.33
  • Plan Savings: $69,986.95
  • Reduction: 87%
High-Dollar Services: Savings Summary:

3. Waterbury, CT

Sixteen-day hospital stay for the treatment of chronic kidney disease and heart failure

  • Room and Board: $99,154.56
  • Laboratory: $13,385.80
  • Billed Charges: $162,934.74
  • ClaimDOC Allowed: $34,347.66
  • Plan Savings: $128,587.08
  • Reduction: 79%
High-Dollar Services: Savings Summary:

4. New Hyde Park, NY

Outpatient chemotherapy for the treatment of Crohn’s disease

  • Pharmacy: $55,099
  • Billed Charges: $58,310.75
  • ClaimDOC Allowed: $13,700.43
  • Plan Savings: $44,610.32
  • Reduction: 77%
High-Dollar Services: Savings Summary:

5. Minneapolis, MN

Twelve-day hospital stay for the treatment of preterm labor and delivery of newborn

High-Dollar Services:

  • Room and Board: $51,948
  • Operating Room: $12,336.50

Savings Summary:

  • Billed Charges: $88,661.22
  • ClaimDOC Allowed: $24,597.33
  • Plan Savings: $64,063.89
  • Reduction: 72%

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.