Dec. 2021 | Get the latest from the best RBP advocates and auditors
Industry Perspective
Stuart Miller, J.D.
Associate Counsel
ClaimDOC Credit Advocacy
Regulation helps the process, but our experience drives the solution.
ClaimDOC has a unique situational awareness of and history with defending patients from healthcare providers who choose profit over patient care. The drive for profit has created a unique ecosystem where patients are treated not as patients but as debtors. Healthcare providers are no longer providing healthcare. They are providing financing services and acting as full-on creditors entering into one-way contracts of adhesion with unsuspecting patient-debtors.
Fortunately, this is not entirely the wild west and regulations have provided a much-needed source of framework for defending against these abhorrent collection practices. Chief among the possible “extraordinary collection actions” an agency could pursue is the furnishing of a negative remark on a patient’s personal credit report. Read More....
Audit Spotlight
Cynthia Swanson, RN, CPC, CEMC, CHC, CPMA
Senior Audit Manager
Wide charge gaps across hospitals for medical scans
Charges and Payment for Diagnostic Imaging Services Factors related to how much a CT scan or MRI will cost depends on healthcare coverage, the insurance provider, the facility’s “in-network” status, the radiologist and state/location where services are provided, and whether the test is performed in a diagnostic imaging center/clinic, hospital inpatient, hospital outpatient setting or other. Charges vary widely for the same imaging test among hospitals and diagnostic imaging centers/clinics. Read More...
Client 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 results bi-monthly. See the savings below and know that together we can make healthcare affordable.
1. East Hartford, CT
Outpatient dialysis treatments (3) for end-stage renal disease
High-Dollar Services:
Clinic Dialysis Treatments (3): $54,564.4
Savings Summary:
Billed Charges: $54,564.49 ClaimDOC Allowed: $980.76 Plan Savings:$53,583.73 Reduction: 98%
2. Pompano Beach, FL
Three-day hospital stay for treatment of heart failure
Disclaimer – The analysis of any medical billing or coding is dependent on numerous facts, regulations, payer policies and codes, as well as the controlling plan description. The information contained herein is intended to provide a real-life example of opportunities for savings through ClaimDOC services but is not intended to provide medical, legal, or financial advice.
Member Experience
Feedback from a Broker
I just wanted to take a minute and let everyone know what a great asset my Account Manager Amy is to ClaimDOC. She is always on top of her game, professional, friendly, trustworthy, knowledgeable, and reliable. I cannot say enough about her and her work ethic. Anytime I have a question I call her and she handles it. She goes beyond the call of duty for us and our clients in my opinion. I would be lost without her support!
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