Audit Cases

94% bill reduction after audit on treatment for unstable angina

 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. Charleston, SC

Hospital outpatient services for the treatment of unstable angina and related procedure

High-Dollar Services:

  • Cath Lab: $44,547

Savings Summary:

  • Billed Charges: $90,216.25
  • ClaimDOC Allowed: $5,229.93
  • Plan Savings: $84,986.32
  • Reduction: 94%

2. Chicago, IL

Three-day hospital stay for the treatment of diabetes and polyneuropathy

  • Laboratory: $174,210.50
  • Billed Charges: $234,673.04
  • ClaimDOC Allowed: $21,401.69
  • Plan Savings: $213,271.35
  • Reduction: 91%
High-Dollar Services: Savings Summary:

3. Overland Park, KS

Hospital outpatient services for the treatment of cleft lip and palate and related surgery

  • Operating Room: $64,470.70
  • Billed Charges: $84,584.56
  • ClaimDOC Allowed: $8,295.67
  • Plan Savings: $76,288.89
  • Reduction: 90%
High-Dollar Services: Savings Summary:

4. Fort Smith, AR

Hospital outpatient services for the treatment of left breast cancer and related surgery

  • Operating Room: $36,108
  • Billed Charges: $65,391.93
  • ClaimDOC Allowed: $6,626.16
  • Plan Savings: $58,765.77
  • Reduction: 90%
High-Dollar Services: Savings Summary:

5. Clermont, FL

Seven-day hospital stay for the treatment of sepsis, acute cholecystitis and related surgery

High-Dollar Services:

  • Pharmacy: $49,572
  • GI Services: $48,523

Savings Summary:

  • Billed Charges: $239,826.15
  • ClaimDOC Allowed: $24,327.68
  • Plan Savings: $215,498.47
  • Reduction: 90%

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.