Looking Back and Going Forward
As we look back at 2020 from a business perspective, it’s almost mind-numbing to summarize the meaningful events that unfolded. Ultimately, I’m so proud that…
Resources
ClaimDOC Balance Bill Process
A balance bill occurs when a provider or hospital receives a fair and reasonable payment from insurance but seeks to collect additional amounts directly…
ClaimDOC Reference Based Pricing
Reference based pricing (RBP) is a generic term used to describe a type of medical claim pricing utilized by self-insured medical plans. Simply put,…
ClaimDOC Member Advocates
ClaimDOC Member Advocates help navigate medical plans and assist with: Finding a doctor or facility for medical treatment Finding a less costly healthcare provider…
80% claim reduction after audit of myasthenia gravis treatment
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…
Audit of outpatient procedure results in a 99% plan savings
Background ClaimDOC’ s comprehensive line-by-line auditing of claims uncovers errors that basic claim repricing and auto-adjudication does not catch, leading to greater savings…
Audit of treatment of complications related to childbirth results in $85,068 plan 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…
COVID-19 billing observations and information
We released an Audit Spotlight in our last newsletter related to a COVID-19 claim. The claim example generated many questions from the brokers…
Audit of COVID-19 hospital stay uncovers unbundled services resulting in huge savings
Background ClaimDOC’ s comprehensive line-by-line auditing of claims uncovers errors that basic claim repricing and auto-adjudication does not catch, leading to greater savings…