YEI Healthcare Division

Solutions by Product Category

YEI provides software, services, and data to clients from providers to suppliers to clearinghouses to payers to software vendors and web service vendors. From multi-state hospital facilities to solo physicians, from laboratory systems to medical device manufacturers, from payers to claims processors, we provide comprehensive support and the most accurate data in the industry.

Each of the below products and data services can be deployed to meet your specific needs now, and can be updated as your needs change. YEI Healthcare: cost-effective products, unparalleled in-house customer service, and broad staff expertise to help with every step of your implementation.

Medical Necessity

ABN Assistant PC/Server

Verify medical necessity quickly and easily before services are provided. Correct coding problems or issue CMS-compliant ABN forms as needed, including cost estimates and specific reasons for non-coverage. Print reference materials for ordering physicians, generate comprehensive reports by procedure, patient, physician, and for audit and training purposes. Includes encoder and full suite of coding tools. Electronic signature capture option. Available in packages for enterprise-level deployment, laboratory, radiology, cardiac services, and physician office. Installation options for server, thin-client (including Citrix), networked, and individual PCs.

ABN Assistant WEB

Verify medical necessity quickly and easily before services are provided. Correct coding problems or issue CMS-compliant ABN forms as needed, including cost estimates and specific reasons for non-coverage. Print reference materials for ordering physicians, generate comprehensive reports by procedure, patient, physician, and for audit and training purposes. Includes encoder and full suite of coding tools. Electronic signature capture option. Available in packages for enterprise-level deployment, laboratory, radiology, cardiac services, and physician office. Completely hosted web application, can be accessed by users at any time from any location.

Medical Necessity Tables

Comprehensive medical necessity files for NCDs, LCDs, and MACs, as well as commercial payers. Single-facility or redistribution licenses. Standard or custom formats, including CPSI, Epic Systems, Fletcher-Flora (FFlex eSuite, LabPak), Iatrics (MNO, LAB e-Laborate), MediTech & other systems. Compiled entirely from original sources by our in-house staff of professional coders and proprietary AI systems, updated daily. The most accurate data in the industry.

Medical Necessity Claims Validation

For medical necessity data files and dictionaries for use in other systems, see Medical Necessity Tables, above. However, to validate a broad range of medical necessity and correct coding rules through single claim submission or batch submission process, we also offer medical necessity modules through YEI ClaimScrub. Web-based solutions for small providers and vendors, and web and fully managed network-appliance solutions for large claim volumes.

Medical Encoders

CodeSearch Pro

Quickly and efficiently locate CPT, HCPCS, ICD-9 and related codes, as well as access pertinent coding tips and guidelines such as CCI (Correct Coding Initiative), fee schedule calculations, modifier usage, and RVUs. Installation options for server, networked systems, and PCs.

EpiCoder WEB

Complete outpatient medical encoder solution, providing access to medical coding tools, codes and references across all specialties. From correct coding to usage guidelines, to billing and reimbursement information, to a medical dictionary, EpiCoder provides comprehensive information in a web-based solution that can be accessed from anywhere.

Coding Engines

Standard or custom coding engines and components for use in third-party vendor products, ASP, and web services.

Exclusion Checking and Provider Identification

EPStaffCheck

Immediately verify that providers, employees, and vendors are not in Medicare's Excluded Party database. Allows individual instant checks as well as automated periodic batch checks. Cost-effective, simple to use, unlimited flat-rate use.

FREE-NPI

A free search tool that allows users to find NPI numbers as well as practice information for physicians, hospitals, and other healthcare providers.

ClaimScrubbing and Data Files

YEI ClaimScrub

Claims scrubbing and processing systems and modules. Available in post-processing modules for clearinghouses and payers, as well as pre-submission modules for providers. All clinical editing system data is prepared in accordance with industry standards including HIPAA and Correct Coding rules, and national grouping, coding, and editing policies. Complete off-the-shelf systems, as well as components which may be integrated with existing systems. Single editing modules to full claims editing suites. HIPAA-compliant transactions and code sets. Server, appliance, ASP, and web-based options. Flexible packages meet the needs of organizations of all sizes.

Data Files

Comprehensive coding, payment and reimbursement data in files ready to load into databases, spreadsheets, third-party software, and more. Procedure (CPT, HCPCS, modifiers, hierarchy, usage flags), diagnosis (ICD-9, ICD-10, hierarchy, usage flags), dental (ADA), medical necessity (LCDs, NCDs, MACs, CCI, NCCI, MUE, allowed/non-allowed diagnoses, allowed/non-allowed procedures, frequency restrictions, permissive edits, multiple required diagnoses, more), facility (APC, DRG, MDC, revenue codes), BETOS, NDC, place of service, crosswalks, fee schedules (ambulance, ambulatory surgery center, anesthesia, DME, physician, clinical lab, PEN, drug), claim format specifications (CMS-1500, UB-04, 270/271, 837), zip code verification, and more.

Consulting Team

The YEI Healthcare Division also provides contract consulting services in the areas of coding, compliance, and reimbursement assistance, denials management, IT infrastructure and managed cabling, custom programming and legacy system migration projects. Services are offered on a limited-engagement or retainer basis. YEI offers expertise in healthcare operations and compliance, coupled with professional software and hardware engineering, to provide simple to comprehensive support based on the client's needs. Each project is assigned to a specific staff member who coordinates all work with the client, and provides a convenient single point of contact.