Audit Cases

97% bill reduction after audit of intraoperative neurophysiology monitoring

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. Bridgeport, CT

Intraoperative neurophysiology monitoring in the operating room

High-Dollar Services:

  • Neurophysiology Monitoring: $67,301.25

Savings Summary:

  • Billed Charges: $67,301.25
  • ClaimDOC Allowed: $1,866.49
  • Plan Savings: $65,434.76
  • Reduction: 97%

2. Thornton, CO

Hospital outpatient services for the treatment of uterine dysplasia and related surgery

  • Operating Room: $84,050.82
  • Billed Charges: $146,405.48
  • ClaimDOC Allowed: $11,445.69
  • Plan Savings: $134,959.79
  • Reduction: 92%
High-Dollar Services: Savings Summary:

3. Kingwood, TX

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

  • Implants: $109,396
  • Medical/Surgical Supplies: $38,987
  • Billed Charges: $220,548.40
  • ClaimDOC Allowed: $19,246.81
  • Plan Savings: $201,301.59
  • Reduction: 91%
High-Dollar Services: Savings Summary:

4. Orlando, FL

Five-day hospital stay for the treatment of chronic pancreatitis and related surgery

  • Surgery: $68,180.00
  • Medical/Surgical Supplies: $48,252.77
  • Billed Charges: $216,697.60
  • ClaimDOC Allowed: $25,053.45
  • Plan Savings: $191,644.15
  • Reduction: 88%
High-Dollar Services: Savings Summary:

5. Hermitage, TN

Hospital outpatient services for the treatment of left breast cancer and radiation treatments (15)

High-Dollar Services:

  • Radiation Treatments (15): $154,747.62

Savings Summary:

  • Billed Charges: $154,747.62
  • ClaimDOC Allowed: $18,971.76
  • Plan Savings: $135,775.86
  • Reduction: 88%

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.