Audit Cases

Audit of six-day hospital stay for the treatment of pelvic inflammatory disease results in a 92% 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. Thorton, CO

Six-day hospital stay for the treatment of pelvic inflammatory disease and related surgery

High-Dollar Services:

  • Operating Room: $52,648.20
  • Room and Board: $22,582.20

Savings Summary:

  • Billed Charges:$172,024.37
  • ClaimDOC Allowed: $15,089.58
  • Plan Savings: $156,934.79
  • Reduction: 92%

2. Fayetteville, GA

Hospital outpatient radiation therapy for the treatment of female genital cancer

  • Radiation Therapy Treatment: $132,049
  • Billed Charges: $132,049
  • ClaimDOC Allowed: $12,245.19
  • Plan Savings: $119,803.81
  • Reduction: 91%
High-Dollar Services: Savings Summary:

3. Pompano Beach, FL

Six-day hospital stay for the treatment of a stroke

  • Laboratory: $28,326.66
  • Radiology: $18,020.05
  • Cath Lab: $17,734
  • Billed Charges: $128,963.96
  • ClaimDOC Allowed: $12,908.89
  • Plan Savings: $116,055.07
  • Reduction: 90%
High-Dollar Services: Savings Summary:

4. Warren, OH

Hospital outpatient services for the treatment of bunion and hallux valgus RT foot and related surgery

 
  • Billed Charges: $63,313.12
  • ClaimDOC Allowed: $11,831.72
  • Plan Savings: $51,481.40
  • Reduction: 81%
  Savings Summary:

5. Knoxville, TN

Seventeen-day hospital stay for the treatment of right leg fracture and related surgery

High-Dollar Services:

  • Implants: $71,031.28
  • Operating Room: $55,669.82
  • Laboratory: $32,137.61
  • Room and Board: $28,310.58

Savings Summary:

  • Billed Charges: $290,674.27
  • ClaimDOC Allowed: $43,122.48
  • Plan Savings: $247,551.79
  • Reduction: 85%

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.