TRACE Saves City of Hope $159K
Provider: City of Hope Cancer Center
Dollar Value: $159,606.69
Communication Event: VoiCert
Challenge: Denied for Lack of Clinical Data
Benefit: Recovery of $159,606.69
A patient presented to City of Hope’s evaluation and treatment center
with acute symptoms. The patient ultimately did not respond to
treatment. Case managers at City of Hope used VoiCert to record several
calls placed to obtain authorization from the patient’s insurance
company. After a rapid decline, the patient received palliative care and
ultimately passed away at the hospital. The hospital used VoiCert to notify
the insurance company of the patient’s death. The payer later denied a
portion of the stay, citing lack of clinical data. City of Hope located the
VoiCert records and sent them to the insurance company. The payer
overturned the denial in the amount of $159,606.69.