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.
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.
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.