Healthcare Data & File Services
YEI provides medical coding and claims processing data with ongoing updates. We continually monitor all data sources so that you don't have to, and we accuracy-check every line of data before it reaches you. Data is provided with a one year subscription so that you receive all updates and changes throughout your subscription year.
Why YEI Data and Libraries?
Yost Engineering is a leading provider of data services and back-end processing services for healthcare clients of every size. In addition to our competitive pricing and rigorous quality controls, we are fully dedicated to serving the needs of our clients, knowing that our success depends on their success.
We provide expertise and assistance for all the data that we provide, and help clients through all phases of data usage, including:
- implementation of data sets
- interpretation and appropriate use of data content
- programming and database logic
- workarounds for legacy systems
- content changes during migration and upgrades
Formats and Content
Our data is generated and published in standard flat-file delimited and XML formats, compatible with any commercial database system. Custom HL7, X12, and other proprietary formats are also available to meet your unique requirements. File format changes, as needed, are also provided at no additional charge to our clients. Data files can be provided in ready-to-use reference file formats, or in files to be used to import the data into third party systems or databases.
Commonly requested content and data elements are listed in the form below, and standard formats can be directly ordered via the Order link below for use within a single physical site. For multi-site use or for deployment to third parties and clients, contact us at support@YostEngineering.com or 888-395-9029 for a redistribution license. All data elements and components can be mixed and matched to support your specific needs, and additional filtering to include or exclude certain types of data is also available as part of our service.
Data Files for medical necessity are compatible with 3rd party systems, such as CPSI, Epic Systems, Merge / Fletcher-Flora (LabPak, FFlex eSuite), Iatrics (MNO, LAB e-Laborate), MediTech, and other vendors. They are also available in custom formats for homegrown systems, for claims scrubbing systems, and for historical purposes.
Available Content Areas Include:
- MEDICAL NECESSITY LIBRARIES (Medicare NCDs, LCDs, Private Payer Edits, Medicaid, and Custom), with procedure-diagnosis matching with complete date specificity to the diagnosis level, non-covered procedures, limited/situational coverage and frequency issues, full edit information returned including policy URLs, policy names, policy numbers, and edit details.
- CODING FILES (including CPT, HCPCS, ICD-9 and ICD-10, Dental, NDC, modifiers, PQRI, POS place of service, BETOS, physical status codes), coding hierarchies, keyword indices, and coding crosswalks, search tools, coding guidelines, short, medium, and long descriptors
- USAGE INDICATORS (frequency, age, maternity, gender male/female, add-on codes, inpatient-only, truncated/primary/secondary codes, conscious/moderate sedation)
- CORRECT CODING (CCI, NCCI/OCE, MUE), mutually exclusive, components, medically unlikely edits, non-reportable codes, modifier over-rides)
- FACILITY CODING (APC, DRG, Revenue Codes, MDC, CPT to APC crosswalks, DRG-MDC-ICD crosswalks)
- REIMBURSEMENT (primary ICD-9 based DRG/MDC grouper, OPPS data, Medicare status codes, global surgery days, multiple procedure payment, bilateral surgery allowance, assistant at surgery allowance, co-surgeon allowance, team surgery allowance, ESRD file sets)
- FEE CALCULATION and Payment Schedules (Physician, RVUs, RBRVS, clinical laboratory, PEN, DME/DMERC/DMEPOS, ambulance, ambulatory surgery, Part B drugs, anesthesia and base units), Medicare and custom, pre/intra/post-op allowances, parenteral/enteral nutrition supply fee schedule
- PHARMACEUTICAL CODING (NDC, drug names, dosage, packaging, forms, administration route, active ingredients, FDA approval numbers, manufacturer name, address, product codes, Rx and OTC designations)
- CLAIM PROCESSING (Claim Adjustment Reason Codes, CARC, Remittance Advice Remark Codes, RARC, taxonomy codes, claim status codes)
- ZIP CODES (US, Canada), 5 and 9-digit verification, city/state verification, zip look-up
- Custom data services (custom dataset compilations, data conversions, legacy system interfaces and crosswalks, web-based data query services, embedded applications/utilities/calculators)
Download a summary of available data files and libraries organized by general content areas.
Delivery and Updates
Our standard data delivery service is via a secure website that clients can log into and download their latest files. Email notices are provided to alert you to updated files when they are posted. For licensed distributors, data may also be dropped or loaded directly into a third-party system via FTP or secure login, acquired via web-based query service, TCP/IP query service, or accessed through components embedded within other software. Updates are made on an ongoing basis, with data posted as frequently as daily, depending on how frequently Medicare and other content sources are making changes.
- updated data made available on a daily (Monday through Friday) basis
- ready-to-use formats to copy to your system
- ready-to-load formats that you upload or import into your system
- files that you redistribute or push to your clients
- files that we redistribute or push to your clients for you
Subscriptions are available for facility and in-house use, as well as for redistribution to clients and use within claims processing systems.
Web-Based Query and Batch Services
In addition to files, we also offer web-based query systems, so that clients can completely avoid data maintenance issues. Web-based services can be custom-developed, or put together on a mix-and-match basis using popular components such as these:
- custom web interfaces and utilities, hosted by us or through your servers
- ActiveX components for easy integration of coding tools and reference data
- AJAX-based client web service (for a desktop application look and feel)
- TCP/IP-based query service
- Data validation services (batch and transaction modes)
- Full claims scrubbing systems (batch and transaction modes)
All solutions can be branded according to your specifications, and seamlessly integrated into your existing services.
In order to maintain accurate and continually updated records for the entire United States and territories, we monitor an extensive list of primary sources. Data is compiled and validated from these primary sources, and extensively audited, using both certified coders and proprietary artificial intelligence systems. Our automated and manual auditing systems consistently correct errors from the original data, and we work with the source organizations in verifying and correcting their incorrect or inconsistent data. All data and systems are maintained in-house by our employees, and no work is outsourced.
Our compulsive attention to quality control and data accuracy is documented by audited results that include:
- 99.99%+ accuracy rate
- Average of only 11 error corrections per year for the past 3 years
- Data updated DAILY
- Over 2.8 million unique medical necessity linkages across over eight thousand CPT and HCPCS codes. The most comprehensive, detailed, and documented data in the entire industry.
Contact us for more information or to get a quote on the data you need.
Standard Files for Direct Order
Direct order is available for the data you need.
For any questions regarding the purchase of data files, please contact our office at 888-395-9029 or support@YostEngineering.com