Audit Cases

Audit of practitioner services for intraoperative nerve and muscle testing results in a 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. Columbus, OH

Practitioner services for intraoperative nerve and muscle testing related to spinal surgery

High-Dollar Services:

  • Practitioner Intraoperative Monitoring: $67,350

Savings Summary:

  • Billed Charges:$67,350
  • ClaimDOC Allowed: $1,025.73
  • Plan Savings: $66,324.27
  • Reduction: 99%

2. Lone Tree, CO

Hospital outpatient services for the treatment of abdominal pain, leg pain and streptococcal infection

  • Emergency Room: $16,922.50
  • CT Scan: $14,408.50
  • Billed Charges: $61,862.20
  • ClaimDOC Allowed: $2,278.71
  • Plan Savings: $59,583.49
  • Reduction: 97%
High-Dollar Services: Savings Summary:

3. Stockton, CA

Two-day hospital stay for the treatment of stroke

  • CT Scan: $49,840
  • Laboratory: $21,528
  • MRI: $18,369
  • Room and Board: 14,908
  • Billed Charges: $119,371
  • ClaimDOC Allowed: $10,263.08
  • Plan Savings: $109,107.92
  • Reduction: 92%
High-Dollar Services: Savings Summary:

4. Rockford, IL

Seven-day hospital stay for the treatment of heart disease and related surgery

  • Medical/Surgical Supplies: $136,388.85
  • Pharmacy: $78,650.52
  • Operating Room: $69,349.65
  • Implants: $33,084.60
  • Laboratory: $32,217.70
  • Room and Board: $31,670.59
  • Billed Charges: $416,247.56
  • ClaimDOC Allowed: $47,546.03
  • Plan Savings: $368,701.53
  • Reduction: 89%
High-Dollar Services: Savings Summary:

5. Sanford, FL

Three-day hospital stay for treatment of chest pain and congestive heart failure

High-Dollar Services:

  • Cath Lab: $50,300.25
  • Operating Room: $29,556.50
  • Nuclear Medicine: $15,139.50

Savings Summary:

  • Billed Charges: $136,820.02
  • ClaimDOC Allowed: $18,489.66
  • Plan Savings: $118,330.36
  • Reduction: 87%

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.