Audit Cases

Audit of physician services for neuromuscular testing results in 99% 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. Macon, GA

Physician services for neuromuscular testing and monitoring during spinal surgery in an ASC

High-Dollar Services:

  • Neuromuscular: $58,050

Savings Summary:

  • Billed Charges: $58,050
  • ClaimDOC Allowed: $396.79
  • Plan Savings: $57,653.21
  • Reduction: 99%

2. Fort Lauderdale, FL

EEG/ECG testing services performed in office setting for monitoring of epilepsy symptoms/seizures

  • EEG setup: $90,000
  • ECG telemetry: $10,000
  • Billed Charges: $100,000
  • ClaimDOC Allowed: $8,086.21
  • Plan Savings: $93,429.46
  • Reduction: 93%
High-Dollar Services: Savings Summary:

3. Brownsville, TX

Four-day hospital stay for the treatment of gallstones, cholecystitis and related surgery

  • Operating Room: $58,497
  • Pharmacy: $24,711.90
  • Laboratory: $23,849
  • CT Scans: $16,884
  • Anesthesia: $16,363
  • Billed Charges: $191,325.90
  • ClaimDOC Allowed: $16,495.89
  • Plan Savings: $174,830.01
  • Reduction: 91%
High-Dollar Services: Savings Summary:

4. Lafayette, IN

One-day hospital say for the treatment of pulmonary embolism and heart disease

  • Operating Room: $51,222
  • Medical/Surgical Supplies: $50,740
  • Billed Charges: $150,223.55
  • ClaimDOC Allowed: $24,646.47
  • Plan Savings: $125,577.08
  • Reduction: 83%
High-Dollar Services: Savings Summary:

5. Mineola, NY

Hospital outpatient services for the treatment of scrotal varices, infertility and related surgery

High-Dollar Services:

  • Operating Room: $35,588.65
  • Implants: $21,248

Savings Summary:

  • Billed Charges: $109,451.82
  • ClaimDOC Allowed: $19,988.62
  • Plan Savings: $89,463.20
  • Reduction: 82%

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.