Comprehensive Medical Claim Auditing

ClaimDOC’s unique approach to medical claim auditing has saved our clients millions. Our process frequently uncovers errors with:

  • Quantity units
  • Unbundling of services
  • Misuse of modifiers
  • Incorrect use of add-on codes
  • Improper assignment of COVID-19 diagnosis
  • Invalid diagnosis on claims
  • Incorrect bill type
  • Improper billing of professional services on hospital claims

Our primary goal is to fairly price all services timely and accurately.


See How Much ClaimDOC Clients Save

ClaimDOC’s line-by-line claim auditing reveals errors overlooked by standard repricing, resulting in significant savings for our members and their health plans.

Audit of Anesthesia Services Leads to 99.8% Savings

Our auditor’s eyes questioned this client’s charge of $52,000.00 for the reported 75 minutes of anesthesia performed by the CRNA.

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Review of Behavioral Health Services Delivers 98% Savings

In this Claims Audit Spotlight, we focus on a claim example where a licensed clinical social worker (LCSW) billed a questionable fee/charge for a service that made our red flag go up. 

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Claim Audit Reveals 720 Minutes of Overbilled Anesthesia Time

In this Audit Spotlight, we focus on identifying and addressing incorrect anesthesia time for anesthesia services being reported/billed on the CMS-1500 claim form/electronic equivalent.

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