Claim of the Week: $3,456 Saved

A patient presented to a free-standing ER with COVID symptoms. Afterwards, the provider charged $4,169 of which the plan would have paid $3,951 for a level 1 ER visit and 7 lab tests. After review, Nokomis denied all of the lab tests because the documentation didn’t support the tests that they billed, ultimately bringing the bill down to $495.

At face value, there may not have been clear reason to question this claim’s accuracy but with the combination of ClaimWise™ and our expert team of coders & analysts, we’re able to find inaccuracies that could have otherwise been overlooked.