ClinAssist Results
During 2010, ClinAssist reviewed $335,220,435 in total billed charges for Commercial and Medicare/Medicaid claims. Of this amount, $163,397683 were total payable charges. Through our Forensic Review we identified more than $30.5 million in gross savings for our clients. This represented an average savings (net of discount) of 21.2%. We also achieved a 93% uphold rate through resolution and sign-off.
Case Studies
Spinal Implants
ClinAssist performed a Forensic Review of claims for an adult patient with a complex lumbar spine surgery.
Diagnostic Related Groups and the Outlier Based Payer
ClinAssist performed a Forensic Review of claims for an adult patient with chronic pelvic infections.
Prematurity and Respiratory Distress
ClinAssist performed a Forensic Review of claims for an infant with extreme prematurity and respiratory distress, analyzing approximately 10,600 line items of charges.
Post Surgery Rehabilitation
ClinAssist performed a Forensic Review of claims for a post surgery rehabilitation patient, analyzing approximately 1,600 line items of charges.
Congenital Heart Defect and Prematurity
ClinAssist performed a Forensic Review of claims for an infant with prematurity and a congenital heart defect, analyzing approximately 7,800 line items of charges.