Audit Cases

99% bill reduction after audit of ASC services for treatment of osteoarthritis of the spine

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 services for the treatment of osteoarthritis of the spine

High-Dollar Services:

  • Ambulatory Surgical Center Services: $18,991.60
  • Radiology: $13,595.40
  • Anesthesia: $9,028.42

Savings Summary:

  • Billed Charges:$71,822.33
  • ClaimDOC Allowed: $566.19
  • Plan Savings: $71,256.14
  • Reduction: 99%

2. Concord, NC

Outpatient dialysis services for the treatment of end stage renal disease

  • Dialysis Treatment (14): $71,792
  • Billed Charges: $92,338.08
  • ClaimDOC Allowed: $4,803.26
  • Plan Savings: $87,534.82
  • Reduction: 95%
High-Dollar Services: Savings Summary:

3. Charleston, SC

Hospital outpatient services for the treatment of heart disease and related procedure

  • Cath Lab: $44,547
  • Billed Charges: $57,894.50
  • ClaimDOC Allowed: $3,535.84
  • Plan Savings: $54,358.66
  • Reduction: 94%
High-Dollar Services: Savings Summary:

4. Ocala, FL

Hospital outpatient services for the treatment of inguinal hernia and related surgery

  • Operating Room: $31,794
  • Anesthesia: $12,485
  • Billed Charges: $61,761.58
  • ClaimDOC Allowed: $4,476.50
  • Plan Savings: $57,285.08
  • Reduction: 93%
High-Dollar Services: Savings Summary:

5. Sanford, FL

Hospital outpatient services for the treatment of atrial fibrillation and related surgery

High-Dollar Services:

  • Operating Room: $225,028
  • Medical/Surgical Supplies: $63,695.38

Savings Summary:

  • Billed Charges: $293,683.51
  • ClaimDOC Allowed: $43,671.62
  • Plan Savings: $250,011.89
  • 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.