Audit of injuries from car collision leads to major 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…
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Audit of spinal surgery results in major client savings
Background ClaimDOC’ s comprehensive line-by-line auditing uncovers errors that basic repricing and auto-adjudication do not catch, leading to greater savings to health plans…
$98,432.13 in plan savings after audit of hip replacement
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…
Full Network Replacement
Traditional program structure for reference-based pricing has included a physician-only network coupled with a vendor capable of auditing and applying revised pricing to facility claims.
Audit of outpatient back surgery results in 91% reduction
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…
A $41,212 surgery bill compounded a patient’s appendicitis pain
Just one of many instances of over-inflated healthcare charges and their complexities.
A how-to guide for reference based pricing
Get the skinny on how the RBP model can save you big bucks.
It’s time to choose: status quo or disruption
Sources agree: the employer’s only hope for controlling spiking health care costs is to opt for insurance industry disruptors.
Cigna sued for RICO violations, “Brazen Embezzlement and Conversion Scheme” -Health Plan Litigation Tsunami: Part 2
A major U.S. insurance carrier settled a $20M lawsuit for defrauding patients, providers and the healthcare industry.