Audit Cases

99% bill reduction after audit of cervical disc 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. Coppel, TX

Ambulatory surgical center services for the treatment of cervical disc disease

High-Dollar Services:

  • Operating Room: $41,284.60
  • Medical/Surgical Supplies: $10,109.04

Savings Summary:

  • Billed Charges: $104,279.72
  • ClaimDOC Allowed: $1,050.76
  • Plan Savings: $103,228.96
  • Reduction: 99%

2. South Boston, VA

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

  • Dialysis Treatments (12): $100,937.16
  • Billed Charges: $145,244.76
  • ClaimDOC Allowed: $4,534.68
  • Plan Savings: $140,710.08
  • Reduction: 97%
High-Dollar Services: Savings Summary:

3. Victoria, TX

Hospital outpatient services for the treatment of colon cancer and immunotherapy

  • Pharmacy: $108,478.00
  • Billed Charges: $110,326.26
  • ClaimDOC Allowed: $14,244.68
  • Plan Savings: $96,081.58
  • Reduction: 87%
High-Dollar Services: Savings Summary:

4. Atlanta, GA

One-day hospital stay for abdominal aneurysm and related surgery

  • Implants: $96,565.79
  • Operating Room: $59,991
  • Billed Charges: $189,395.80
  • ClaimDOC Allowed: $25,185.61
  • Plan Savings: $164,210.19
  • Reduction: 87%
High-Dollar Services: Savings Summary:

5. Crystal River, FL

Outpatient services for the treatment of lumbar disc disorders and related surgery

High-Dollar Services:

  • Operating Room: $201,423.60
  • Implants: $83,167.81

Savings Summary:

  • Billed Charges: $344,986.03
  • ClaimDOC Allowed: $49,152.87
  • Plan Savings: $295,833.16
  • Reduction: 86%

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.