Quality Metrics – Don’t Make Assumptions Based on Headlines
I recently came across a study dealing with “evidence-based medicine” in primary care (Ebell MH, Sokol R, Lee A, et al. How good is the…
Resources
Audit of surgical removal of brain malignancy results in 92% 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…
Egregious Charges for Anesthesia Services Raises Red Flags
Background ClaimDOC’s comprehensive line-by-line review of claims uncovers errors that basic claim repricing and auto-adjudication does not catch, leading to greater savings for health plans…
ISU Basketball Breakout Star Audi Crooks Signs NIL Agreement with ClaimDOC
Crooks to serve as brand ambassador for West Des Moines-based company in multiyear partnership WEST DES MOINES, IOWA (MARCH 11, 2024) — Iowa State University…
Champagne for My Real Friends, Real Pain for My Sham Friends: Proposed Class Action Lawsuit Puts Spotlight on Fiduciary Duty Under ERISA
In early February of this year, a proposed class action lawsuit was filed against the company Johnson & Johnson and their Pension & Benefits Committee,…
What is Hospital Outpatient “Observation” Care?
Background When patients are seen and treated in a hospital, they are assigned either an “outpatient status” or an “inpatient status.” Hospital Outpatient Care and…
Introducing ClaimDOC’s Updated Portal
ClaimDOC’s updated portal offers unique provider access and pricing insights, unlike any other tool in the market. It helps our clients stay compliant with transparency…
98% savings found after audit of freestanding ER bill
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…
2024 Looking Back and Going Forward
We started Industry Perspectives 3 ½ years ago with the goal of providing relevant insights from our team of experts, with a ClaimDOC spin. Consistent…