Hospital Bill Audit Service Saving Examples

Benefit Review
$12,148 Savings - A patient had a kidney transplant with a total charge of $39,485. The kidney acquisition fee was $22,000 of the total charges, but the patient's benefit limit was $10,000 for organ acquisition; therefore, $12,148 was overpaid.

Billing Errors
$34,272 Savings - A patient received 64 units of oxygen. The charge for each unit of oxygen was $8.50. The total charge should have been $544, but the hospital billed the 64 units at $544 each for a total of $34,816. This was an overcharge of $34,272.

Physician Order
$4,668 Savings - A patient was hospitalized for 132 days with total charges of $374,612. The patient was in and out of intensive care. When the patient was transferred to a semi-private room the staff continued to provide intensive monitoring service (cardiac monitoring and frequent blood gases) even though the physician had discontinued these services. Seventy-three services ($4,668.25) were provided without a physician order.

Coordination of Benefits
$22,846 Savings - The patient was admitted for a fractured ankle. A record indicated that this was due to a fall at work and therefore was payable under workers' compensation.