Audit Cases

96% bill reduction after outpatient dialysis treatment

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. Martinsville, VA

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

High-Dollar Services:

  • Dialysis Treatments (13): $109,226

Savings Summary:

  • Billed Charges: $109,226
  • ClaimDOC Allowed: $4,555.59
  • Plan Savings: $104,670.41
  • Reduction: 96%

2. Scottsdale, AZ

ASC services for the treatment of rotator cuff repair right shoulder and related surgery

  • Surgery: $113,724
  • Billed Charges: $113,724
  • ClaimDOC Allowed: $6,685.15
  • Plan Savings: $107,038.85
  • Reduction: 94%
High-Dollar Services: Savings Summary:

3. Aurora, CO

Twenty-two day hospital stay for the treatment of stroke and related surgery

  • Operating Room: $152,264.72
  • Room and Board: $88,894.47
  • CT Scans: $65,309.10
  • Pharmacy: $39,607.74
  • Billed Charges: $520,599.12
  • ClaimDOC Allowed: $40,045.12
  • Plan Savings: $480,554
  • Reduction: 92%
High-Dollar Services: Savings Summary:

4. Cartersville, GA

Outpatient hospital observation services for the treatment of injuries following a MVA

  • CT Scans: $32,677
  • Laboratory: $27,352
  • Billed Charges: $92,788.28
  • ClaimDOC Allowed: $7,167.09
  • Plan Savings: $85,621.19
  • Reduction: 92%
High-Dollar Services: Savings Summary:

5. Pittsburgh, PA

Hospital outpatient services for the treatment for ovarian cancer and chemotherapy

High-Dollar Services:

  • Pharmacy: $54,203

Savings Summary:

  • Billed Charges: $63,945.25
  • ClaimDOC Allowed: $5,615.93
  • Plan Savings: $58,329.32
  • Reduction: 91%

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.