Audit Cases

92% bill reduction after audit for six-day hospital stay for treatment of stroke

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. Wichita, KS

Six-day hospital stay for the treatment of stroke

High-Dollar Services:

  • MRIs: $34,709
  • CT Scans: $33,669.04
  • Room and Board: $21,256

Savings Summary:

  • Billed Charges: $143,019.19
  • ClaimDOC Allowed: $11,374.37
  • Plan Savings: $131,644.82
  • Reduction: 92%

2. Jacksonville, FL

Ambulatory surgery center services for the treatment of impingement syndrome of left shoulder

  • ASC Surgery Services: $64,026.05
  • Billed Charges: $64,026.05
  • ClaimDOC Allowed: $6,195.58
  • Plan Savings: $57,830.47
  • Reduction: 90%
High-Dollar Services: Savings Summary:

3. Fort Lauderdale, FL

Four-day hospital stay for the treatment of stroke

  • Pharmacy: $120,267.10
  • Minor Surgery: $94,047
  • Medical/Surgical Supplies: $58,381.60
  • Billed Charges: $468,661.03
  • ClaimDOC Allowed: $47,099.20
  • Plan Savings: $421,561.83
  • Reduction: 90%
High-Dollar Services: Savings Summary:

4. Paducah, KY

Hospital outpatient services for the treatment of pain in right foot, tendinitis and related surgery

  • Implants: $67,150.54
  • Medical/Surgical Supplies: $11,762.20
  • Operating Room: $9,703.86
  • Billed Charges: $125,325.10
  • ClaimDOC Allowed: $17,051.49
  • Plan Savings: $108,273.61
  • Reduction: 86%
High-Dollar Services: Savings Summary:

5. Colorado Springs, CO

Hospital outpatient services for the treatment of abdominal pain and medication therapy

High-Dollar Services:

  • Observation: $13,337.13
  • IV Infusion: $17,963.45

Savings Summary:

  • Billed Charges: $67,900.57
  • ClaimDOC Allowed: $11,321.21
  • Plan Savings: $56,579.36
  • Reduction: 83%

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.