Audit Cases

Audit of ground and air transport for the treatment of a stroke 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. Fort Wayne, IN

Ground and air transport to between hospitals for the treatment of stroke

High-Dollar Services:

  • Air Ambulance: $220,450

Savings Summary:

  • Billed Charges: $232,050
  • ClaimDOC Allowed: $11,959.62
  • Plan Savings: $220,090.38
  • Reduction: 95%

2. Davenport, FL

Three-day hospital stay for the treatment of right kidney cancer and related surgery

  • Operating Room: $197,244.20
  • Billed Charges: $274,565.14
  • ClaimDOC Allowed: $16,871.20
  • Plan Savings: $257,693.94
  • Reduction: 94%
High-Dollar Services: Savings Summary:

3. San Antonio, TX

Nine-day inpatient hospital stay for the treatment of brain cancer and related surgery

  • Operating Room: $101,766
  • Implants: $62,403.90
  • Billed Charges: $343,406.90
  • ClaimDOC Allowed: $39,016.38
  • Plan Savings: $304,390.52
  • Reduction: 89%
High-Dollar Services: Savings Summary:

4. Toledo, OH

One-day hospital stay for the treatment of iliac artery aneurysm and related surgery

  • Implants: $102,128.46
  • Operating Room: $59,517
  • Billed Charges: $209,352.86
  • ClaimDOC Allowed: $42,320.50
  • Plan Savings: $167,032.36
  • Reduction: 80%
High-Dollar Services: Savings Summary:

5. Evansville, IN

Eighteen-day hospital stay for the treatment of diverticulitis and related surgery

High-Dollar Services:

  • Operating Room: $51,504
  • Pharmacy: $46,182

Savings Summary:

  • Billed Charges: $159,991.80
  • ClaimDOC Allowed: $40,712.93
  • Plan Savings: $119,278.87
  • Reduction: 75%

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.