DirectAccess+ Saves Plan Nearly $57K on Member’s Back Surgery
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
A one-day hospital stay for treatment of spinal stenosis with related surgery.
Hospital bill: $906,040.42
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$98,498.23** |
$19,699.65 |
|
DirectAccess+ |
$41,861.94*** |
$8,372.39 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $56,636.29 | Member savings: $11,327.26
Portland, Maine
A one-day hospital stay for the treatment of stenosis of a coronary artery stent with related surgery.
Hospital bill: $121,861.99
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$91,308.64** |
$18,261.73 |
|
DirectAccess+ |
$35,241.09*** |
$7,048.22 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $56,067.55 | Member savings: $11,213.51
Columbus, Ohio
A three-day hospital stay for treatment of temporal lobe cancer with related surgery.
Hospital bill: $112,396.10
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$90,667.13** |
$18,133.43 |
|
DirectAccess+ |
$44,869.30*** |
$8,973.86 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $45,797.83 | Member savings: $9,159.57
Wilkes Barre, Pennsylvania
A two-day hospital stay for treatment of acute pericarditis.
Hospital bill: $63,879.13
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$52,411.50** |
$10,482.30 |
|
DirectAccess+ |
$22,489.55*** |
$4,497.91 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable
Plan savings: $29,921.95 | Member savings: $5,984.39
Hampton, Virginia
A four-day hospital stay for treatment of epilepsy, acute respiratory failure, alcohol withdrawal and acidosis.
Hospital bill: $71,224.33
|
Plan |
Patient Responsibility* |
|
|
Traditional Network Plan |
$40,416.17** |
$8,083.23 |
|
DirectAccess+ |
$21,806.00*** |
$4,361.20 |
*20% coinsurance | **Median commercially contracted price | ***ClaimDOC allowable