Audit Cases

Audit of surgical removal of brain malignancy results in 92% savings

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. New York, NY

Physician services for surgical removal of brain malignancy

High-Dollar Services:

  • Surgery: $51,776.00

Savings Summary:

  • Billed Charges: $51,776.00
  • ClaimDOC Allowed: $3,906.45
  • Plan Savings: $47,869.55
  • Reduction: 92%

2. Ocala, FL

Hospital outpatient services for the treatment of left radial fracture and related surgery

  • Operating Room: $66,985.82
  • Billed Charges: $157,983.05
  • ClaimDOC Allowed: $16,666.89
  • Plan Savings: $141,316.16
  • Reduction: 89%
High-Dollar Services: Savings Summary:

3. Orlando, FL

Hospital outpatient services for the treatment of atrial fibrillation, atrial flutter and bradycardia

  • Cardiology: $301,700
  • Billed Charges: $459,833.08
  • ClaimDOC Allowed: $49,698.91
  • Plan Savings: $410,134.17
  • Reduction: 89%
High-Dollar Services: Savings Summary:

4. Scottsdale, AZ

Eleven-day hospital stay for the treatment of sepsis and acute respiratory failure with hypoxia

  • Room and Board: $67,124.00
  • Billed Charges: $230,140.08
  • ClaimDOC Allowed: $43,331.80
  • Plan Savings: $186,808.28
  • Reduction: 81%
High-Dollar Services: Savings Summary:

5. Elgin, IL

Fourteen-day hospital stay for the treatment of pneumonitis due to inhalation of food

High-Dollar Services:

  • Room and Board: $77,290.00

Savings Summary:

  • Billed Charges: $182,071.00
  • ClaimDOC Allowed: $40,103.73
  • Plan Savings: $141,967.27
  • Reduction: 78%

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.