Our Thoughts On Best Practices.

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Winning the Battle on Health Care Costs

April 2021
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Health Care Interview

Industry conferences generally illuminate growing trends and broad, often brilliant ideas. Distinguished presenters glide through slides and issues providing probable causes and ideal answers. One can almost feel the enthusiasm ricocheting off the walls of Ballroom A… We’re going to make it after all!

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How & Why We Negotiate Medical Claims

February 2021
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Nokomis Health | Claim Negotiations

It is an all too common occurrence: a motorist is seriously injured in a car accident and requires emergent treatment. According to the National Safety Council, nearly 6,300 people sustain serious injuries every day in the U.S. due to motor vehicle accidents1. Most of these people are immediately transported to the nearest hospital for care.…

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Schemes, Errors & Scams – How Uncommon Claim Review Findings Lead to Savings

January 2021
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Nokomis Health | Stories from the Front Line

Nokomis Health’s coding team was reviewing a client’s out of network laboratory and a batch of genetic testing claims raised some questions. The claims appeared to be legitimate – the CPT code was valid, the diagnosis code supported the charge, the NPI and TIN were correct – but the charges were very high for the…

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The Power of the 59 Modifier

October 2020
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Nokomis Health | Modifier 59

Do you know how much power there is in a single two-digit number? Most payors and health plans don’t realize the impact that the 59 modifier can have on claim costs. Adding this simple modifier to a CPT code allows that code to bypass several code edits, resulting in erroneous and often incorrect payments. Providers have…

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