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 (TOBs 12x and 22x) effective October 1, 2005. These data elements are mandated by the Health Insurance Portability and Accountability Act (HIPAA).

  1. Admission date
  2. Admission type
  3. Admission diagnosis
  4. Patient's status code
  5. Admission source code

You will need to access MAP1681 for roster bill entry. Enter the Date of Service, Type of Bill, Revenue Code, Healthcare Common Procedure Code System (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?
If you are having difficulty connecting to your network and you do not know which company you connect to, such as VisionShare (612-460-4310) or IVANS (866-503-9670, please contact your corporate office for assistance.

When calling the DDE help desk at WPS Medicare, please be specific with the ID you would like 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 "Invalid Signon Attempt- Contact Security," "M179 Security Information invalid, APR is not available," "suspended," "revoked," and "log in already signed on."

Your password must contain exactly 8 characters, in the following format: three letters followed by two numbers followed by three letters. All letters should be lower case. Do not try to use the same letter 6 times or repeat the same three letters on both sides of the password

Examples:

abc12def - valid password
aaa12aaa - invalid password
abc12abc - invalid password

FORMAT in changing passwords

LOGON-ID:
PASSWORD:
NEW PASSWORD:

When you are changing a password, make sure you hit the Enter key after typing in the logon ID and password, even though the cursor will drop down to the New Password line automatically. After you have received a message at the bottom of the screen stating that the password has expired, you should type your new password on the New Password line and press Enter. You will then have a message at the bottom of the screen to type in your new password again and hit Enter. Once you have done this, your password should be changed.

If you are receiving a message saying you are already signed on, please make sure you are properly logging off by typing LOGOFF on the selection line and pressing the Enter key. Resetting the password will not correct the problem.

Who do I contact to obtain additional IDs?
You should contact the Systems Department at 866-518-3295, Option 2.

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 866-503-9670.

When entering or adjusting a claim, do I need to change my Type of Bill (TOB)?
When necessary yes, typing over the TOB field will change the type of bill. Adjustments TOBs 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 the Common Working File (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
  5. "Y" in the SV field on page 1

A suppressed claim will be in status location TB9997 and have the X in the "TPE-TO-TPE" field or a "Y" in the SV field (page 1 of claim, the very upper right corner, underneath the page number).

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?
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. F10 to return to your previous page

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)

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 third 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

What are the telephone numbers for Part A and Part B Customer Service?
Part A Customer Service can be reached at 866-518-3285
Part B Customer Service can be reached at 866-503-3807

Page Last Updated: Tuesday, 29-Dec-2009 13:42:13 CST