Our Thoughts on Best Practices

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Featured Claim Savings

Featured Claim Savings: $7,266

September 2022
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Elderly man sitting on a bench wearing a mask holding his hand up to his mask because he is coughing

A 60-year-old patient presented to an ER with COVID symptoms. Their health plan would have paid $8,659, but after reviewing records, Nokomis found upcoding and charges for services not rendered. We ultimately saved the plan $7,266.

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Featured Claim Savings: $17,190 Saved

September 2022
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Pregnant woman in labor with her hand on her belly and her other hand holding a man's hand. A medical physician has their hand on her belly as well.

A 30-year old female presented to a birth center for the delivery of one child. Her health plan would have paid $17,190, but after reviewing records, Nokomis found incorrect codes – they billed for multiple births, and additional services that were not rendered. We ultimately saved the plan the entire $17,190.

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Featured Claim Savings: $15,498 Saved

September 2022
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Physician holding a stethoscope up to the chest of a patient

A 34-year-old patient presented to a free standing ER for heart palpitations. After reviewing records, Nokomis found incorrect code assignments, codes for services not provided, and inappropriately billing for supplies. We ultimately saved the plan $15,498. We’re not in the business of cherry-picking claims to review or denying care, we’re aiming for an honest and…

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Featured Claim Savings: $858 Saved

August 2022
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Close up of an analog alarm clock with a person lying in bed in the background

A 64-year-old male went to a sleep clinic for a sleep disorder. His plan would have paid $858, but after reviewing records, Nokomis found that none of the codes were supported; there was upcoding and the plan was being billed for services not rendered. We ultimately saved the plan all $858.

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Featured Claim Savings: $2,470 Saved

August 2022
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Physician putting her hands on a pregant woman's belly

A 37-year-old woman was presented at her midwife appointment. Her plan would have paid $2,470, but after reviewing records, Nokomis found upcoding and incorrect code assignments, and ultimately saved the plan all $2,470.

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Featured Claim Savings: $73,409 Saved

August 2022
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Operating room with doctors and nurses working on a patient

A 31-year-old male underwent abdominal surgery for an ulcerated colon. His plan would have paid $73,409, but after reviewing records, Nokomis found many incorrect code assignments and ultimately saved the plan all $73,409. It’s important to note that this recommendation was not appealed!

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Featured Claim Savings: $424 Saved

August 2022
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Medical physician smiling at a patient

A 28-year-old patient presented to their physician with an alcohol dependency issue. Their plan would have paid $424, but after reviewing records, Nokomis found they were being charged for the incorrect level of service, ultimately saving the plan the entire $424.

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Featured Claim Savings: $1,107 Saved

August 2022
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Two doctors looking at an x-ray

A 43-year-old woman visited her oral surgeon’s office for a surgical procedure to remove and biopsy a tooth. Her health plan would have paid $2,014, but after reviewing records, Nokomis found that the documentation supported only one claim line, ultimately saving the plan $1,107. Medical record review matters and these claims might seem OK at…

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Featured Claim Savings: $5,270 Saved

July 2022
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A 52-year-old woman underwent gallbladder surgery. The plan would have paid $12,090; however, after reviewing records, we discovered that the documentation did not support the codes, ultimately saving $5,270.

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Featured Claim Savings: $17,160 Saved

July 2022
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A 43-year-old woman underwent back surgery to implant a spinal cord stimulator to alleviate her back pain. The plan would have paid $17,160, but further investigation uncovered that the documentation did not support the items in the claim. We recommended denying this claim, saving the plan $17,160.

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