Save with Line-by-Line Medical Claim Audits

Medical billing is inconsistent and hard to understand. Traditional PPOs offer little to no help to employers. With ClaimDOC, you don’t need to become a healthcare expert to save and offer richer benefits to your employees. ClaimDOC is a national medical claim auditing and member advocacy company driven to deliver a successful and sustainable health plan for employers and their employees.

It’s estimated that as high as 80% of all medical bills contain errors. Our proprietary claims management and audit system is custom engineered to allow for detailed line-by-line audits to uncover errors typically not caught by claim scrubbers and automation. While many reference based pricing vendors only review balance bills and appealed claims, our in-house certified audit team reviews all UB-04 facility claims, ensuring maximum savings.

ClaimDOC’s unique approach to 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(es) 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.

Audit Spotlight Case Studies

Learn How to Reduce Large Claim Spend on Your Health Plan

 


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