DirectAccess+ Cuts the Cost of Critical NICU Care
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 five recent audit results showcasing substantial savings.
Plano, Texas
An 83-day hospital stay for a premature infant with multiple complications.
Hospital bill: $1,897,266.42
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$523,149.00** |
$104,629.80 |
|
DirectAccess+ |
$241,538.91*** |
$48,307.78 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $281,610.09 | Member savings: $56,322.02
Kissimmee, Florida
A 12-day hospital stay for the treatment of sepsis, candidal stomatitis and respiratory failure with related surgery.
Hospital bill: $183,730.26
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$164,724.06** |
$32,944.81 |
|
DirectAccess+ |
$30,697.13*** |
$6,139.43 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $134,026.93 | Member savings: $26,805.38
Chicago, Illinois
An six-day hospital stay for the treatment of sepsis and acute respiratory failure with a related procedure.
Hospital bill: $197,468.78
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$128,058.40** |
$25,611.68 |
|
DirectAccess+ |
$52,452.00*** |
$10,490.40 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $75,606.40 | Member savings: $15,121.28
Templeton, California
A 12-day hospital stay for the treatment of a stroke.
Hospital bill: $233,017.37
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$81,248.00** |
$16,249.60 |
|
DirectAccess+ |
$36,842.09*** |
$7,368.42 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $44,405.91 | Member savings: $8,881.18
Atlanta, Georgia
A three-day hospital stay for the treatment of a benign lesion pituitary gland with related surgery.
Hospital bill: $146,689.67
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$52,062.66** |
$10,412.53 |
|
DirectAccess+ |
$20,032.44*** |
$4,006.49 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable