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Data Sheet: HealthEdge Source — Data Reference Module

Data Reference, which can be accessed through your instance of Source, provides insight into any current or historical fee schedules, rates, payment policies, and provider-level data.

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Data Reference is an essential tool accessed through your instance of HealthEdge Source™ (Source), offering unparalleled insights into both current and historical fee schedules, rates, payment policies, and provider-level data. This comprehensive resource ensures healthcare professionals have access to critical information needed for informed decision-making.

Key Features

  • CMS Rates: Research Medicare rates and prospective payment data, including Diagnosis-Related Group (DRG) and Ambulatory Payment Classification (APC) statistics for all participating areas.
  • CMS Policies: Investigate policy statistics, such as Medically Unlikely Edits (MUE) and National Correct Coding Initiative (NCCI) by provider, region, and payment system.
  • CMS Providers: Look up essential rates and statistics, including Disproportionate Share Hospital (DSH) payments, wage index, and other Medicare-related ratios.
  • Codes: Access date-sensitive statistics on ICD-9, ICD-10, and HCPCS (Healthcare Common Procedure Coding System) coding systems used for claims processing.

Advantages

  • Current Data: Information in Data Reference is refreshed routinely as part of our regular two-week update cycle, ensuring the most up-to-date data is always available.
  • Seamless Integration: Housed within the same instance of Source as your production environment, providing a seamless experience without the need for multiple platforms.
  • Flexibility: Data is exportable for external use, allowing for versatile application across different analytical needs.
  • Historical Data: Search by effective date to track historical changes in data, offering a comprehensive view of trends over time.

About the Author

Christopher Walker is the Product Marketing Manager at HealthEdge for the Payment Integrity solution, Source. Specializing in data-driven strategies, integrated analytics, and competitive intelligence, Christopher crafts messaging that helps healthcare providers and payers improve operational efficiency, reduce member costs, and enhance health outcomes.

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