Medical Billing Errors on Healthcare Claims — Fraud or Abuse?
In the context of medical coding, fraud involves intentional misrepresentation of services billed. Abuse refers to the falsification of information that was likely an innocent…
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Patient Saves $5,738.68 After Surgery to Fix Broken Hip Prosthesis
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…
What Is a Fair Charge for a Blood Glucose Test?
A blood glucose test is done to measure the amount of glucose in the patient’s blood using a reagent strip test method. Ancillary staff in…
$49,300.63 in Plan Savings After Audit of Six 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…
Why the Variation of Physician Fees for the Same Medical Service?
Let us zero in on a service many physicians bill: CPT code 99291. Defined as “critical care, evaluation and management of the critically ill or…
Member Saves $5,624.94 on Hospital Stay and Surgery
With DirectAccess+ — ClaimDOC’s reference-based pricing health plan solution — clients and members achieve maximum protection and savings. To establish savings information, ClaimDOC analyzes commercial…
Mystery Markups: CT Scan Charges Vary Across Hospitals
A computerized tomography scan, also called a CT scan, uses a combination of X-rays and a computer to create detailed images of the body. It…
Audit of Hospital Stay Saves Member $20,540.10
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…
10 Common Medical Billing Errors
As healthcare costs continue to skyrocket, an escalated need exists for closer analysis of healthcare claims to identify egregious charges, improper medical coding and…