Audit Cases

Audit of chest pain treatment leads to 97% 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. Miami, FL

Hospital outpatient services for the treatment of chest pain

High-Dollar Services:

  • CT Scan: $13,873.00

Savings Summary:

  • Billed Charges: $56,306.00
  • ClaimDOC Allowed: $1,688.13
  • Plan Savings: $54,617.87
  • Reduction: 97%

2. Las Vegas, NV

Four-day hospital stay for the treatment of cellulitis of left arm and related procedure

  • Pharmacy: $30,181.00
  • Billed Charges: $117,954.00
  • ClaimDOC Allowed: $9,727.66
  • Plan Savings: $108,226.34
  • Reduction: 92%
High-Dollar Services: Savings Summary:

3. Tyler, TX

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

  • Operating Room: $66,482.00
  • Billed Charges: $94,017.64
  • ClaimDOC Allowed: $10,426.09
  • Plan Savings: $83,591.55
  • Reduction: 89%
High-Dollar Services: Savings Summary:

4. Hattiesburg, MS

Eight-day hospital stay for the treatment of sepsis and related surgery

  • Room and Board: $32,601.50
  • Billed Charges: $184,356.30
  • ClaimDOC Allowed: $20,908.54
  • Plan Savings: $163,447.76
  • Reduction: 89%
High-Dollar Services: Savings Summary:

5. Englewood, CO

ASC surgery for the treatment of  metatarsalgia and hallux rigidus of left foot 

High-Dollar Services:

  • Surgery: $64,813.00

Savings Summary:

  • Billed Charges: $83,738.00
  • ClaimDOC Allowed: $10,183.93
  • Plan Savings: $73,554.07
  • 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.