Member Saves Nearly $6,000 on Appendicitis Treatment
With DirectAccess+, clients and members achieve maximum protection and savings. To establish savings information, ClaimDOC analyzes commercial contract pricing from data disclosed by hospitals and health plans. Using Turquoise Health to find the median commercially contracted price, we can show a fair estimate on the true savings being generated for the plan and the member. Licensed healthcare professionals conduct comprehensive line-by-line claim auditing to uncover errors typically not caught. Following are four recent audit results showcasing substantial savings.
San Luis Obispo, California
A two-day hospital stay for appendicitis and related surgery.
Hospital bill: $125,895.00
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$41,837.42** |
$8,367.48 |
|
DirectAccess+ |
$13,379.99*** |
$2,676.00 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $28,457.43 | Member savings: $5,691.48
Orlando, Florida
A three-day hospital stay for the treatment of sepsis and rectal abscess.
Hospital bill: $89,231.69
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$32,059.99** |
$6,412.00 |
|
DirectAccess+ |
$11,963.69*** |
$2,392.74 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $20,096.30 | Member savings: $4,019.26
Ocala, Florida
A three-day hospital stay for the treatment of diabetes, syncope, and a collapse and fall.
Hospital bill: $91,223.43
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$20,422.00* |
$6,126.60 |
|
DirectAccess+ |
$10,237.03*** |
$3,071.11 |
*30% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $10,184.97 | Member savings: $3,055.49
Foley, Alabama
A four-day hospital stay for the treatment of kidney disease and congestive heart failure.
Hospital bill: $94,894.49
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$21,460.77* |
$4,292.15 |
|
DirectAccess+ |
$13,501.73*** |
$2,700.35 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $7,959.04 | Member savings: $1,591.80