Audit Cases

Audit of outpatient dialysis services results in 95% 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. Cleveland, OH

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

High-Dollar Services:

  • Dialysis Treatments (9): $53,795.45

Savings Summary:

  • Billed Charges: $53,795.45
  • ClaimDOC Allowed: $2,920.14
  • Plan Savings: $50,875.31
  • Reduction: 95%

2. Orange Park, FL

Five-day hospital stay for the treatment of ruptured tendons, right foot/ankle, reflux disease and related surgeries

  • Operating Room: $76,291
  • Laboratory: $36,182
  • Room and Board: $27,085
  • GI Procedures: $25,389
  • Billed Charges: $249,599.50
  • ClaimDOC Allowed: $17,341.14
  • Plan Savings: $232,258.36
  • Reduction: 93%
High-Dollar Services: Savings Summary:

3. Charleston, SC

Hospital outpatient services for the treatment of tachycardia and related procedure

  • Medical/Surgical Supplies: $181,704
  • Cath Lab: $74,085
  • Pharmacy: $29,500
  • Billed Charges: $307,168
  • ClaimDOC Allowed: $26,041.74
  • Plan Savings: $281,126.26
  • Reduction: 92%
High-Dollar Services: Savings Summary:

4. Aurora, CO

Six-day hospital stay for the treatment of a stroke with complications

  • CT Scans: $30,298.60
  • Laboratory: $29,568.35
  • Room and Board: $25,398.42
  • Emergency Room: $18,545.04
  • Billed Charges: $145,231.76
  • ClaimDOC Allowed: $18,220.84
  • Plan Savings: $127,010.92
  • Reduction: 88%
High-Dollar Services: Savings Summary:

5. Manhasset, NY

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

High-Dollar Services:

  • Implants: $73,676.99
  • Cath Lab: $33,480

Savings Summary:

  • Billed Charges: $113,363.19
  • ClaimDOC Allowed: $14,387.10
  • Plan Savings: $98,976.09
  • 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.