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Saved a Bundle with Bill Reviews

HHC Group Success Story Save a Bundle with Bill Reviews

A five and a half month old baby girl suffering from acute respiratory failure with hypoxia, pneumonia due to Hemophilus influenza and hypotension was first treated in the emergency room and then admitted. She remained hospitalized for 21 days. HHC Group performed a free prescreen to determine if the potential savings justified a full Line Item Bill Review. They were and HHC conducted a full review.

Claim Type: In-Network

Provider Type: Children's Hospital

Location: Midwestern United States

Treatment: The baby was placed on a ventilator for more than 96 hours. An endotracheal airway was inserted into her Trachea. She received continuous nebulizer therapy as well as transfusions of non-autologous red blood cells via a peripheral vein using a percutaneous approach.

Provider Charges: $478,602.08

Discrepant Charges: $170,809.08 - The hospital billed for room and board and separately for ventilator management, daily oxygen reading and exhaled CO2 monitoring which are customarily included in the room and board charge. Additionally, they billed for routine nursing care as well as for individual breathing treatments and continuous nebulizing which are normally included in routine nursing care.

Corrected Charges: $307,809.08

Client Savings: $170,793

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