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With a mission of providing smarter and more accurate ways to handle, manage and review the medical claims adjudication process, Nokomis Health is leading the way in the claim review and payment integrity services arena.

Nokomis Health: A National Leader in Medical Claim Review and Payment Integrity Services

With a mission of providing smarter and more accurate ways to handle, manage and review the medical claims adjudication process, Nokomis Health is leading the way in the claim review and payment integrity services arena.

In addition to its experienced staff, the company offers its ClaimWise review engine, a non-intrusive claim review process that is designed to save the most money while ensuring the greatest accuracy.

Nokomis Health also offers medical claim review services to third party administrators and payers. The company’s team of healthcare coders, claims analysts and medical professionals understand the risk areas inherent in medical claims. They also apply sophisticated analytics to find patterns within the data which may indicate fraud, waste, and abuse.

As maintaining data integrity for processing claims can be difficult, Nokomis Health also provides enrollment and provider data audit services, which increase accuracy in enrollment, benefit set up, billing and provider data.

For example, the company reviewed enrollment records for a client and found an error rate of approximately 18 percent – primarily due to poor data entry and lack of quality assurance practices.

Nokomis Health bases its success on looking at the bigger picture for its customers. The company looks at the entire history of the patient and the practitioner, and goes deeper than just codes to identify patterns within the data.

As a result, payers and plan sponsors gain actionable insights, as well as the ability to uncover tremendous cost savings.

To learn more about Nokomis Health, please click here.

 

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