Member Saves Nearly $17K After 21 Days in Hospital
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.
Panama City, Florida
A 21-day hospital stay for the treatment of a heart attack with a related cardiac catheterization laboratory procedure.
Hospital bill: $513,715.26
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$180,142.04** |
$36,028.41 |
|
DirectAccess+ |
$96,911.51*** |
$19,382.30 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $83,230.53 | Member savings: $16,646.11
Tallahassee, Florida
A four-day hospital stay for the treatment of coronary artery disease with a related cardiac catheterization laboratory procedure.
Hospital bill: $530,018.10
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$113,758.00.** |
$34,127.40 |
|
DirectAccess+ |
$62,449.59*** |
$18,734.88 |
*30% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $51,308.41 | Member savings: $15,392.52
Dallas, Texas
A seven-day hospital stay for the treatment of alcoholic cirrhosis with ascites and related surgery.
Hospital bill: $226,201.31
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$41,882.32** |
$4,188.23 |
|
DirectAccess+ |
$21,128.96*** |
$2,112.90 |
*10% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $20,753.36 | Member savings: $2,075.33
Brooksville, Florida
A three-day hospital stay for the treatment of viral intestinal infection and pneumonia.
Hospital bill: $130,845.41
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$27,837.00** |
$5,567.40 |
|
DirectAccess+ |
$14,899.60*** |
$2,979.92 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $12,937.40 | Member savings: $2,587.48
Louisville, Kentucky
A two-day hospital stay for the treatment of secondary brain cancer.
Hospital bill: $104,884.28
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$24,161.40** |
$4,832.28 |
|
DirectAccess+ |
$13,341.99*** |
$2,668.40 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $10,819.41 | Member savings: $2,163.88