MCEActive Code Editor
Medicare Claim data editing and validation
Overview:
The MCEActive™ Enterprise Code Editor DLL takes inpatient claim information including patient age, sex, and discharge status along with detail diagnosis and procedure code data and validates against specific criteria prior to DRG assignment and reimbursement calculation to assure correct grouping and reimbursement.
Software developers and system integrators! The MCEActive™ Code Editor DLL is the easiest way to add CMS-compliant inpatient claim data validation logic to your systems or applications. By simply incorporating the MCEActive™ Code Editor DLL into your application, setting the input property values, and executing the CodeEdit method you can validate all the input claim data elements. The data validation performed by MCEActive™ is 100% compliant with CMS specifications. These components allow you to add Medicare data editing functionality to your systems and applications built for the Windows client environment.
The MCEActive™ Code Editor DLL is the ideal solution for claims processing applications, data warehousing and data analysis, claim review, compliance auditing, and much more.
Availability:
There are two types of MCEActive™ Code Editor DLLs to match your system architecture:
Desktop versions of the MCEActive™ Code Editor DLL utilizes Microsoft Access databases for fast and efficient in-line processing.
The MCEActive Enterprise™ Code Editor DLL is available in .Net format and utilizes Microsoft SQL Server data components for high-performance in large-scale enterprise and web-based applications.
The MCEActive™ Code Editor DLL validates inpatient claim data for five fiscal years of Medicare specifications.
Features include:
Versions available for plug-in compatibility with .Net or ActiveX capable development environments
100% CMS compliant DRG data validation including:
1. Invalid Diagnosis or Procedure Code14. Procedures allowed for males only2. Invalid Age15. Manifestation code as Principal Diagnosis3. Invalid Sex16. Non-Specific Principal Diagnosis4. Invalid Discharge Status17. Questionable Admission5. E-Code as Principal Diagnosis18. Unacceptable Principal Diagnosis6. Duplicate of PDX19. Non-Specific O.R. Procedure7. Diagnoses for Newborns and Neonates20. Non-Covered Procedure8. Pediatric diagnoses for children up to1721. Open Biopsy Check9. Maternity diagnoses22. Bilateral Procedure10. Adult diagnoses for age > 1523. Limited Coverage11. Diagnoses allowed for females only24. Wrong Procedure Performed12. Procedure allowed for females only25. Procedure inconsistent with length of stay13. Diagnoses allowed for males only
Scalable:
The MCEActive™Code Editor DLL comes in versions suitable for desktop applications as well as Enterprise Versions designed for high-performance large-scale applications that utilize Microsoft SQL Server.
Compatible with the leading Windows development environments including:
Microsoft Visual Studio
Microsoft .Net Core (.Net, 6, 7, 8)
Microsoft .Net Framework 4.6.2+
Microsoft SQL Server
Licensing:
The MCEActive™ Code Editor DLL is licensed based upon usage.
For a single site installation, like a health plan, hospital, or university, the MCEActive™ Code Editor DLL is licensed for internal use based on the size of the installation.
For a Software Developer including the MCEActive™ Code Editor DLL in a software package for distribution to an end user, a distribution agreement is required. Terms: an initial license fee and a per-site fee for each MCEActive component.
Send e-mail to salesinfo@microdynmed.com or call for more information and pricing.