Audit Cases

97% bill reduction after atherosclerotic heart disease 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. Plano, TX

ASC services for the treatment of atherosclerotic heart disease and related surgery

High-Dollar Services:

  • Surgery: $56,996

Savings Summary:

  • Billed Charges: $57,333
  • ClaimDOC Allowed: $1,831.48
  • Plan Savings: $55,501.52
  • Reduction: 97%

2. Houston, TX

Hospital outpatient services for the treatment of knee osteoarthritis and related surgery

  • Operating Room: $60,484
  • Implants: $40,937.40
  • Billed Charges: $141,681
  • ClaimDOC Allowed: $19,434.85
  • Plan Savings: $122,246.15
  • Reduction: 86%
High-Dollar Services: Savings Summary:

3. Savannah, GA

Eight-day hospital stay for treatment of pancreatic cancer, acute kidney failure and related surgery

  • Operating Room: $14,779.80
  • Radiology: $9,200
  • Gastrointestinal: $8,278.32
  • Billed Charges: $83,178.35
  • ClaimDOC Allowed: $16,542.13
  • Plan Savings: $66,636.22
  • Reduction: 80%
High-Dollar Services: Savings Summary:

4. Indianapolis, IN

Hospital outpatient services for the treatment for abdominal aortic anerysm and related surgery

  • Implants: $82,822
  • Operating Room: $31,238
  • Billed Charges: $147,028.97
  • ClaimDOC Allowed: $36,935.03
  • Plan Savings: $110,093.94
  • Reduction: 75%
High-Dollar Services: Savings Summary:

5. South Bend, IN

Twenty-four day inpatient stay for the treatment of a stroke w/ related surgery

High-Dollar Services:

  • Room and Board: $1,135,120
  • Operating Room: $113,673
  • Pharmacy: $81,915.85
  • Implants: $77,509

Savings Summary:

  • Billed Charges: $596,355.35
  • ClaimDOC Allowed: $188,083.14
  • Plan Savings: $408,272.21
  • Reduction: 68%

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.