Audit Cases

99% bill reduction after audit for ASC services for the treatment of back pain

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. Coppell, TX

Ambulatory Surgical Center (ASC) services for the treatment of back pain and related surgery

High-Dollar Services:

  • Ambulatory Surgical Center: $100,469.72

Savings Summary:

  • Billed Charges: $100,469.72
  • ClaimDOC Allowed: $1,015.64
  • Plan Savings: $99,454.08
  • Reduction: 99%

2. Babylon, NY

Physician hospital outpatient services for the surgical treatment of brain aneurysm

  • Physician Surgery Charges: $115,000
  • Billed Charges: $115,000
  • ClaimDOC Allowed: $2,106.89
  • Plan Savings: $112,893.11
  • Reduction: 98%
High-Dollar Services: Savings Summary:

3. Englewood, FL

Hospital outpatient services for the treatment of uterine/ovary disorders and related surgery

  • Operating Room: $272,981.49
  • Billed Charges: $350,737.01
  • ClaimDOC Allowed: $13,464.39
  • Plan Savings: $337,272.62
  • Reduction: 96%
High-Dollar Services: Savings Summary:

4. Concord, NC

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

  • Dialysis Treatments (13): $192,725.93
  • Billed Charges: $102,725.83
  • ClaimDOC Allowed: $4,278.04
  • Plan Savings: $98,447.79
  • Reduction: 96%
High-Dollar Services: Savings Summary:

5. Rockford, IL

Hospital outpatient services for the treatment of kidney stones and related surgery

High-Dollar Services:

  • Medical/Surgical Supplies: $33,273.05
  • Operating Room: $15,508.90

Savings Summary:

  • Billed Charges: $57,016.76
  • ClaimDOC Allowed: $9,388.15
  • Plan Savings: $47,628.61
  • 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.