Setting a New Standard in Claim Review

Nokomis is known for its innovative and knowledge-based approach to identifying medical claim savings for payors.

We built our claim review engine from the ground up so that we could incorporate the best industry standards, analytical thinking and comprehensive methods for conducting claim reviews. Our proprietary claim review engine, ClaimWiseTM, is designed to be the best in the industry.

Along with ClaimWiseTM, we employ a highly skilled and experienced team of certified coders, claim analysts, and medical professionals who have a deep understanding of claims, claim systems, coding, billing, and reimbursement. Our comprehensive suite of services supports payors and health plans throughout their entire claim adjudication process, leading to increased savings and proper claim payments.

We are here to prove that there is a better way to ensure payment accuracy, every time, on every claim.

Services Overview

We tailor our claim management services to fit your needs.

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CLAIM REVIEW

We provide concurrent claim review services.

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AUDIT

We conduct payor and plan audits to ensure data accuracy and identify risk areas.

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CONSULTING

As industry experts, we offer a wide variety of consulting services to payors and health plans.

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OUT OF NETWORK CLAIMS

We reduce out of network claim costs through claim negotiations and partnerships with travel and specialty networks.

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Industry Statistics

$3T

Total health spending in America adds up to $3.0 trillion (18% of GDP).

80%

As many as 80% of medical bills presented by hospitals and other healthcare providers contain errors.

$60B

Amount U.S. healthcare system loses annually to fraud, waste and abuse.

Why Choose Nokomis?

With us you gain a long-term partner.

The Nokomis team is among the best in the industry in understanding claims. They are able to identify trends in large claim data sets, pinpoint areas of opportunity, and describe recommended courses of action to achieve savings. They act with integrity in all that they do.

Leading Regional Health Plan

I have had the pleasure of working closely with the Nokomis team in a variety of capacities. The depth and breadth of their knowledge is rare in our industry, and they have repeatedly demonstrated an ability to deliver meaningful results that positively impact an organization’s bottom line. They have also shown an ability to balance the business and operational needs of their clients, while keeping sight of the client’s strategic goals. I would not hesitate to recommend Nokomis to any of my clients.

National Healthcare Consultant