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$71,745.06 in Hospital Savings After One-Day Hospital Stay

With DirectAccess+, clients and members achieve maximum protection and savings. To establish savings information, ClaimDOC analyzes commercial contract pricing from data disclosed by hospitals and health plans. Utilizing the median commercially contracted price gives a fair estimate on the true savings being generated for the plan and the member. Licensed healthcare professionals conduct comprehensive line-by-line claim auditing to uncover errors typically not caught. Following are five recent audit results showcasing substantial savings.

1. Valhalla, New York

One-day hospital stay for the treatment of stenosis peripheral vascular stent and related procedure

Traditional Network Plan Hospital Bill: $108,421.51 Median Commercially Contracted Price $107,753 Patient Responsibility 20% Coinsurance: $21,550.60

DirectAccess+ Hospital Bill: $108,421.51 ClaimDOC Allowable $36,007.94 Patient Responsibility 20% Coinsurance: $7,201.59 Plan Savings: $71,745.06 Member Savings:  $14,349.01

2. Tulsa, Oklahoma

Eight-day hospital stay for the treatment of intestinal adhesions, partial obstruction and related surgery

Traditional Network Plan Hospital Bill: $129,113.68 Median Commercially Contracted Price $115,740.01 Patient Responsibility 20% Coinsurance: $23,148

DirectAccess+ Hospital Bill: $129,113.68 ClaimDOC Allowable: $43,681.64 Patient Responsibility 20% Coinsurance: $8,736.33 Plan Savings: $72,058.37 Member Savings: $14,411.67

3. Davenport, Florida

Three-day hospital stay for the treatment of pneumonia & acute respiratory failure w/ hypoxia

Traditional Network Plan Hospital Bill: $80,287.68 Median Commercially Contracted Price $28,586 Patient Responsibility 20% Coinsurance: $5,717.20

DirectAccess+ Hospital Bill: $80,287.68 ClaimDOC Allowable: $12,997.63 Patient Responsibility 20% Coinsurance: $2,599.53 Plan Savings: $15,588.37 Member Savings: $3,117.67

4. Omaha, Nebraska

Four- day hospital stay for the treatment of gallbladder calculus w/ related surgery

Traditional Network Plan Hospital Bill: $81,310.99 Median Commercially Contracted Price $40,580 Patient Responsibility 10% Coinsurance: $4,058.00

DirectAccess+ Hospital Bill: $81,310.99 ClaimDOC Allowable: $27,498.40 Patient Responsibility 10% Coinsurance: $2,749.84 Plan Savings: $13,081.60 Member Savings: $1,308.16

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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.