Specimen report
What my review looks like on your desk.
One invented invoice, read line by line, so you can see the deliverable before sending a real one.
Specimen figures only; no real patient, no real hospital, no real claim.
The file, as it would reach me
| Field | Specimen value |
|---|---|
| Case | Male, 54, German national, resort stay in Hurghada |
| Presentation | Two days of fever, vomiting and dehydration; admitted from the hotel clinic |
| Invoice as received | EUR 18,460 · inpatient, 7 nights, intensive-care tariff for 3 of them |
| Documents provided | Itemised invoice, translated discharge summary, guarantee of payment |
| Documents requested by me | Complete original clinical record, nursing notes, medication chart |
Findings, line by line
| Line | Billed | Finding | Position |
|---|---|---|---|
| Length of stay | 7 nights | The full record documents clinical recovery and normal oral intake by day 3; nursing notes show no active treatment after day 4. | 4 nights |
| Intensive care, 3 days | 3 days ICU tariff | No ventilation, no vasopressors, no monitoring records beyond standard observations. The record supports high-dependency observation for 1 day at most. | 1 day, ward tariff + |
| IV antibiotics, broad spectrum, 7 days | 7 days, two agents | Cultures were never taken; the documented picture is viral gastroenteritis with dehydration. One empirical agent for 3 days is the defensible maximum. | 3 days, one agent |
| Imaging | CT abdomen, twice | The second CT, on day 5, has no documented indication and no change in clinical state. | First CT only |
| Consumables & sundries | EUR 2,210 | Daily "monitoring kit" and duplicated infusion sets; the medication chart supports roughly a third of the volume billed. | EUR 740 |
| Service percentage | 12% on all lines | A stacked margin with no contractual basis against this payer. | Removed |
The reading, in prose
This file shows the classic anatomy: a genuine illness, genuinely treated, wrapped in an invoice built toward the payer's ceiling rather than the patient's needs. The patient was truly admitted and truly needed fluids, antibiotics and observation. The clinical record supports a 4-night ward admission with one day of close observation. The invoice describes a 7-night stay crowned by three days of intensive care that the hospital's own notes do not document. Nothing here requires an accusation; every position above is stated as a question of what the record can stand behind.
Settlement recommendation
The recommended figure is not a negotiation posture. It is the amount this invoice can defend if every line is met on the clinical record, which is exactly how I present it to the hospital, physician to physician, without accusation.
What I would need from you to produce this
The invoice and the translated summary you already hold. I obtain the complete record. Turnaround is agreed before the file moves; a single-invoice read is a matter of days, not weeks.
Dr Hossam Elkholy
Physician, Former Hospital Medical Director, Red Sea, Egypt
Independent Medical Cost-Containment Consultant
hossam@elkholy-consulting.com · +20 10 1034 4449
This is the deliverable: a written verdict per line, defensible to your auditor. The first live case is free.