The above forensic medical bill audit report, based on the itemized bill from Peak of the Mountain Medical Center contains, $7,085 in non-conforming charges. This means that unless Peak of the Mountain Medical Center can substantiate the non-conforming charges with relevent clinical data from the date and time of service, they must be eliminated from the bill. If we assume all non-conforming charges can be eliminated, this audit serves as prima facie evidence for a billing reduction from $52,175 to $45,090. After a patient has accounted for all allowable, or non-allowable charges, on their itemized bill they can then request a reduction for balance settlement or charity care.

Let us assume that a hospital eliminates $7,085 in non-allowable charges and offers a 20% reduction for full balance settlement. Under these circumstances the patient account would represent the following:

$52,175 (Original Bill) – $7,085 (audit reduction findings) = $45,090

The hospital next applies a 20% reduction for full balance settlement = $45,090 * 20% = $9,018*

New correct bill and patient balance: $45,090 – $9,018 = $39,972

*Hospitals and clinics may offer a ”haircut” bill reduction, upon request, for patients who settle the full balance immediately. Offered amounts may vary between hospitals and clinics and Medical Bill Forensics LLC makes no representation that a hospital or clinic will make such an offer. Further, hospitals and clinics may offer bill reductions based on patients qualifying for charity care; Medical Bill Forensics LLC makes no representation that a hosptial or clinic may offer a patient may qualify for, or receive, charity care.