Direct Data Entry (DDE/Remote)

Home Provider Part A Self Service DDE

What information is needed to submit a roster bill through Direct Data Entry (DDE)?
Change Request 4242, implemented 07/03/06, indicated that the following data elements are to be present when billing Inpatient Part B services (TOB’s 12x and 22x) effective October 1, 2005. These data elements are mandated by the Health Insurance Portability and Accountability Act (HIPAA).

a) admission date
b) admission type
c) admission diagnosis
d) patient’s status code
e) admission source code

You will need to access MAP1681 for roster bill entry. Enter the Date of Service, Type-Of-Bill, Revenue Code, HCPCS and Charges per Beneficiary then press the enter key, which will provide you with access to enter data in the new fields.

What information is needed to reset my DDE password?
WPS Medicare can only reset Ids that begin with MU (user id) or YM (login id).  If your ID does not begin with YM or MU, please contact your internal help desk for assistance.

If you are having difficulty connecting to your network and you do not know which company you connect to such as AT&T, Perot, HCA, Medi.com, please contact your corporate office for assistance.  For AT&T users please call 1-800-727-2222 for assistance.

When calling the DDE help desk at WPS, please be specific with the ID you would like reset (MU or YM).  Each ID has its own password and this will help ensure that the correct ID is reset.  Please use zero for the number and O for the letter when giving us the ID. Also state any messages you are receiving such as “suspended”, “revoked”, and “log in already signed on”.

Your password must contain exactly 8 characters, including a number inside your password.  A number cannot be the first or last digit of your password.

FORMAT in changing passwords
LOGONID: ===>                 YMAXXXXX     (tab)
PASSWORD: ===>             XXXXXXXX given by DDE help desk  (tab)                   
NEW PASSWORD: ===>                XXXXXXXX password you create   (tab)
(enter twice) ===>                           XXXXXXXX verify  your password        (enter)

If you get a message stating the password does not match, the system has timed you out.  To avoid this problem, always start your password change by retyping your logon ID even though it shows on your screen, then enter the temporary password and the new password twice.  When you hit enter it will take you to the next page and give you a message that the password has been successfully altered.

If you are receiving a message saying you are already signed on, please make sure you are properly logging off by typing “CSSF LOGOFF.  Resetting the password will not correct the problem.

Who do I contact to obtain additional Ids for MU or YM numbers?
You should contact the Electronic Data Interchange (EDI) department at 866-734-6656.

Who do I contact if I have questions about PC-ACE PRO32 enrollment, electronic submission, downloading software or retrieving RA's to our mailbox within 30 days of processed date?
You should contact the Electronic Data Interchange (EDI) department at 866-734-6656.

When entering or adjusting a claim, do I need to change my T.O.B?
When necessary yes, typing over the TOB field will change the type of bill. Adjustments TOB must end in a 7 (xx7). Each sub-menu automatically defaults to TOB 13x, 11x or 21x respectively.

How can I determine if a claim is suppressed or did not post to CWF?
You can determine this by checking the following fields:

  1. Menu 01 (inquiries), Sub menu 12 (claims)
  2. Type in Medicare number and select your claim
  3. Page 2, then F2,
  4. "X" in the "TPE-TO-TPE" field

A suppressed claim will be in status location TB9997 and have the X in the "TPE-TO-TPE" field.

A claim that did not post to CWF will be in PB9997 and have the X in the "TPE-TO-TPE" field.

What processed claims can providers adjust on DDE?

  1. Paid claims in status location PB9997
  2. Rejected claims in RB9997 that do not have an X in the "TPE-TO-TPE" field.
  3. MSP paid or rejected claims (PB9997 or RB9997)

What fields are required for adjustments? 
When entering an adjustment on the DDE system you will need the following:

  1. Page 1 condition code (D0- E0). The description of these codes can be found in the DDE manual screen print on page 299.
  2. Adjustment Reason code (above Doctor's last name) on page 3. You can find this on SC 16. Hit enter twice or under Inquires (01) sub menu 16.
  3. MSP rejected claims. Please change the status location from a "P" to an "R".

What are the new changes on page 2 for DDE?

Rate:

  • When adding a rate make sure you add three digits after the decimal (i.e. 20.000).

Deleting a line:

  • Place a "D" on the first digit of the revenue code.
  • Press "Home" key (cursor must be under page #).
  • Press "enter" key. (This entire line will be deleted).

Adding a line:

  • The new line must be added below your total charges.
  • The lines will be sorted in numerical order by pressing the home key and enter.

How do I add more than 2 modifiers?

Adding modifiers on claims entry:

  1. Go to page 2
  2. F11
  3. Manually place your cursor next to the existing modifiers to add the additional modifier (s)
  4. F6 to scroll down
  5. To return to your previous page, F10

Adding modifiers on claim corrections or adjustments:

  1. Delete the entire line
  2. Add a new line and follow the steps under claim entry above to add the additional modifier(s)

When typing HIQA or FSS0 and I receive the following error message,  “Check that the transaction name is correct”, what should I do?
Check your product selection screen. These are the following products you may select for each command.Remember you may only select the FISS REGION you are assigned.
**Note** You must first logon with your YM# before typing the HIQA or FSS0 command.

HIQA FSSO(#zero)
TEXAS MEDICARE FISS REGION 1
CALIFORNIA MEDICARE
FLORIDA MEDICARE
GREAT WESTERN MEDICARE		 FISS REGION 2
FISS REGION 3
FISS REGION 4

What is the NPI (National Provider Identification) field on HIQA?
This field is not currently being used, as NPI has not been implemented yet.

When entering information on HIQA use the "tab" key to skip this field. DO NOT use the enter or down arrow key. If you do not use the "tab" key, you will receive a message stating your NPI cannot be identified.

Where are therapy caps located on HIQA?
Therapy caps are located on the 3rd paragraph on the first page.  See below for an example. “PT TBM  1740.00” means “physical therapy to be met” and the amount is what is remaining for that Medicare beneficiary to use toward the CAP.  This example shows the Medicare beneficiary has not utilized any physical therapy yet so the full $1740.00 is available.

PART A YR      BLD  3 PT TBM  1740.00  OT TBM  1740.00                     
CATASTROPHIC A:   DED-TBM BLOOD CO-SNF  FULL-SNF  DOEBA  DOLBA  DED-APL   

YEAR   89         0056000   03   008     142    000000 000000 0000000     

Page Last Updated: Tuesday, 15-Jul-2008 10:34:14 CDT