Medical Necessity

YEI works with payers to support and improve their medical necessity processing activities. Our streamlined, AI-based medical necessity tools and documentation options can provide:

• Standard datasets based on Medicare rulesets
• Custom datasets
• Data for updating your current edit system on a one-time basis
• Ongoing support and maintenance services
  
  

Data is formulated specifically to your requirements, and can include cross-referenced fields from an array of data sources. Using our affordable and personalized service provides the following benefits, allowing you to concentrate on processing claims and managing policy-level information:

• Yearly code updates and crossovers provided automatically
• Policies published directly to web, print-ready formats, or electronically distributed to staff and providers
• Umproved communication with providers
• Eliminate typopgraphical errors
• Keep providers informed on a timely basis
• Prevent discrepancies caused by outdated codes or descriptions

Coding Data

YEI provides CPT, HCPCS, ICD-9 and related information in custom formats with ongoing updates. Additional coding and claims processing files are also available, including CCI, RVUs, pricing, modifier applicability, coding guidelines, and more. 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 available as a one-time upload or with ongoing maintenance and updates.

Excluded Party Verification

Are you doing business with providers who have been excluded from Medicare or other government program participation, or who appear on national security watchlists? Have you checked your staff for compliance as well? With our EP-StaffCheck web service, you can immediately verify that a provider, staff member, or potential hire is not in any of the excluded party databases. Our service monitors all the watchlists, and reports back in one simple format, eliminating the need to track multiple sources and run multiple checks. You can also load staff or provider information in batch files for periodic rechecking.

Custom Data Preparation and Management

Other data that you need? Migrations between systems? Data manipulation for extraction or retroactive review purposes? Our custom data files and data programming services can be a fast and affordable solution. Contact us with your project for a no-obligation quote.

Request More Information

Contact us, with no obligation, for more information about how we can help you!