Non-Public Data

Data Request Inquiry

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Applications Open

Non-public APCD data are now available for request. Please request an application to get started.  You can  Download this pdf file. preview the content of the application prior to completing in order to determine what information will be needed for submission. 

If you are uncertain of whether the data request process is appropriate for your use case or have any questions regarding the application process, please submit a Data Request Inquiry.

Who is eligible to request Non-Public Data?

Types of data requesters include researchers, government entities, payers, providers/health systems, industry, and employers. Data requesters must be affiliated with an organization. 

What are the requirements for receiving access to Non-Public Data?

All Non-Public Data releases must align with Georgia APCD objectives. Within the data request application, the requester must justify how the data use will benefit the public. Data requesters must also have the methodological expertise and security infrastructure to analyze and protect the data. Data requests should be limited to the minimum data necessary to answer a research question. Additional justification is required for certain data elements to ensure antitrust compliance and to protect sensitive data.

How much will Non-Public Data cost? 

Costs will vary depending on the type and quantity of data being requested.  For more details, see Data Access Fees.

Non-Public Data Request Application Content

Requesters of Non-Public Data will need to submit an application, including the following:

Requester information
  • Organization information
  • Personnel & collaborators
  • Prior experience using claims data
Project plan
  • Project description (background, goals, & objectives)
  • Project purpose & alignment with APCD objectives
  • Project start & end date
Data specification
  • How APCD data will be used
  • Specific data elements requested
  • Justification for requesting sensitive data elements
Expected outputs
  • Intended products or reports
  • Plans for publishing or disseminating findings
Data privacy
  • Plans & infrastructure for protecting the data
  • Techniques to prevent reidentification of data

Additional application elements may include:

  • A copy of an Institutional Review Board (IRB) protocol for the research
  • A Data Use Agreement (DUA)
  • A Data Management Plan

What is the process for requesting Non-Public Data?

The Non-Public Data Request process is as follows. Step 1: Submit application inquiry. Step 2: Work with Intake Coordinator to refine request. Step 3: Submit data request application. Step 4: Application intake. Step 5: Application review by Security Team (if necessary). Step 6: Application review by Data Release Review Committee (DRRC). Step 7: Administrator makes final release decision. Step 8: Execute Data Use Agreement (DUA) and make payment. Step 9: Data release.

What data elements are contained in Non-Public Data?

All data requests should be limited to the minimum necessary data. Most Non-Public Data releases will be fully de-identified. When necessary for the research topic, "limited identifiers" such as 5-digit zip codes or dates of service can be made available.

Some data may be classified as sensitive for a variety of reasons including antitrust regulations and sensitive conditions, medications, and procedures, or other criteria as defined by the Data Governance Planning Team.

Standard Modules

In order to simplify the selection of data elements from the APCD, we have developed a set of standard data modules, listed below. If you have data needs that are not listed here, please contact us.

Member Information 

  • Age 
  • Gender 
  • Zip
  • Race (limited)
  • Ethnicity (limited)

Member Coverage

  • Dates of coverage
  • Insurance coverage class (Medical, Pharmacy, Dental)

Medical Claims 

  • Date of service (admission/discharge dates as applicable)
  • Care site type (inpatient, outpatient, pharmacy)
  • Procedure code (modifier codes)
  • Diagnosis codes 

Medical Claims Costs 

  • Charge amount
  • Plan paid amount 
  • Member co-pay 
  • Member deductible 
  • Member coinsurance 
  • Submitter supplied allowed amount 
  • Claim status

Pharmacy Claims 

  • Dispensing date
  • NDC code 
  • Drug name  
  • Quantity / Month supply 

Pharmacy Claims Costs

  • Charge amount
  • Plan paid amount  
  • Member co-pay  
  • Member deductible  
  • Member coinsurance  
  • Submitter supplied allowed amount 
  • Dispensing fee
  • Claim status

Dental Claims

  • Date of service
  • Service provided
  • Dental quadrant
  • Tooth number
  • Tooth surface

Provider Information

  • Provider information with Synthetic IDs
    • Provider synthetic ID
    • Specialty
  • Provider Information with NPI
    • NPI 
    • Name
    • Organization name
    • City
    • State
    • Zip
    • Specialty

Payer Information

  • Submitter Name
  • Payer ID / NAIC ID
  • Plan Name
  • Product Type (Commercial, Medicare, Medicaid)
  • Product Subtype (FFS, Managed Care)


Notes
ZIP may be represented as ZIP-3 or ZIP-5 based on prior responses. Dates may be represented as a full date or as a year and sequence within the year based on prior responses. Payer, Provider, and combined Payer and Provider information may be limited based on requestor type.