Answers to Frequently Asked Questions about FISS

Home Provider Part A Frequently Asked Questions

When will providers be issued new software to install?
There is no new software to install. The provider will access DDE the same way they currently access the APASS Remote system.

How can providers print the screens/reports on DDE?
They can print the screen by using their 'print screen' key on their pc. If a provider wants to download the screen/report into a Microsoft document (word, excel) they will need to work with their internal staff to determine how that can best be done in their office.

If providers submit claims through a clearinghouse, are they going to have to change the way they submit information to the clearinghouse?
There should not be any changes required due to FISS. However, their clearinghouse may make changes that will alter what the provider submits. The provider will need to contact their clearinghouse to see if any changes are necessary.

What will happen to claims in locations other than 65 on the transition date?
Claims in location statuses other than 65 will convert to the equivalent location status on FISS.

Will providers still have to call in for duplicate overrides?
Yes, that process will not change.

How will PCAce be affected by FISS?
PCAce is compatible with FISS. No changes will be needed for transition, and any future updates will be supplied by WPS.

Will beneficiary and claim history be converted to FISS?
All claim and beneficiary history will be converted to FISS upon transition.

How can providers receive copies of the training materials if they never received them?
The training materials are on our web site at www.mutualmedicare.com. They can be printed by the providers.

How can a provider find a processed claim that needs to be adjusted without the ICN?
The provider can access processed claims by the HIC number of the beneficiary.

Why does WPS default the Release of Information (RI) field on FISS DDE to 'N' instead of 'Y'?
WPS cannot assume that a provider has a signed statement from the beneficiary. It is the provider's responsibility to acquire the information release from the beneficiary.

Why is WPS going to delete claims in provider return location (65) that have not been fixed by the transition date?
WPS is taking steps to mitigate risks inherent with transition, and lowering the amount of claims on suspense is one of those steps. Internal staff will be working down the claims in the locations that are the responsibility of WPS. We plan to be current with edits, so that the only claims that need to be converted are those being held due to system problems or CMS holds.

Are there fewer fields in the pricer/grouper under FISS than in the APASS Remote system?
No, the fields are the same.

If a provider keys a claim and runs into an error that cannot be corrected at that time, can the claim be saved and the correction made later, or will they lose the entire claim?
Claims must be corrected before they can be stored. If a claim cannot be corrected, the provider will lose it and must re-key it when they get the correct information.

Does the F9 save the claim or send it into WPS for submission?
It does both.

How will we be able to check claims on the payment floor, or if they are cabling?
By the status location of the claim.

Is working location 65 the same as RTP on FISS?
Yes. RTP is Return to Provider, and is the FISS equivalent to location 65 on APASS.

When there is an overflow of diagnosis codes, where are the providers supposed to put them? Presently they put them in the remarks-is this the same as FISS?
There is room for 9 diagnosis codes on FISS. This is the same as APASS. If there are extra diagnosis codes, you will still need to put them in remarks.

Does the receipt date change when the claim goes to an RTP location?
Yes. If a claim is returned to the provider, it is 'unclean' and the receipt date will change to the date the claim is fixed (becomes clean).

When a claim is offline (purged), is it going to take 7 days to retrieve these claims?
Retrieval of purged claims takes a weekly cycle, so the length of time it takes to retrieve depends on the day the retrieval is requested. Retrieved claims will be available on Monday.

Can line item denials be adjusted by providers? Can the provider remove the line denied item?
Line denials cannot be adjusted. The provider will need to send a corrected claim for any adjustments that need to be made.

Will errors on the system come up in red so that the providers can easily identify them?
Not on all screens. Providers will need to use the reason code to guide them.

Can you view an offline (purged) claim in inquiry?
No, it must be retrieved.

What type of claims will require hardcopy adjustments in FISS?
The same types that do now in APASS. There will be no changes to this process due to the transition to FISS.

Will the system be up on weekends?
At this time, the online availability will remain the same as it is with APASS Remote. Those hours are 6:30 am - 6:30 pm CST from Mon-Thur, and 6:30 am to 10:30 pm CST on Friday. We will be analyzing the processing times to determine if we can keep the system up longer.

Will the payment cycle be different on FISS?
No. The payment cycle is determined by Medicare regulations, and is not dependent upon claim processing system.

Will the ICN's on claim history be assigned a DCN after transition?
Yes. This is part of history conversion. All claims on the system will be assigned a DCN.

Will the remittance advice look the same under FISS?
Yes. The remittance advice is a standard format determined by CMS, and is not dependent upon claim processing system.

Can you just type in the narrative instead of the ICD-9 code and get a listing of the ICD-9 codes applicable (i.e. 'diabetes' instead of 25000)?
No. You will still need to type in the correct ICD-9 codes.

Will APC information be available on DDE? It is currently available on Remote under PPS Paid Claim History.
Yes, that information is available on the paid claim.

Will providers have to type in the Carrier and Locality for the HCPCS code lookup?
No. The carrier and locality is determined by the provider number.

Will providers have the same access to CWF that they now have?
Yes. Providers will continue to access CWF in the same manner they do now.

How often will check history be updated?
Check history shows the last 3 checks the provider received. It is updated as often as the provider gets paid --if they are on daily pay, it will get updated every day to show their last 3 checks. If they are a weekly pay provider, it will get updated every week. When it updates, the newest one is added and the oldest one falls off.

Will the format from the UB change on DDE?
FISS actually follows the format of the UB92 much more closely than APASS Remote. The format will not change from the UB92, but it will change from APASS.

When medical records are received, will edit 359 still be used to acknowledge receipt?
No. Providers will be able to tell that we have received the records because the claims will move into location status SMRDOC.

Are new user log-ons going to be required to access the FISS system or will our current user log-ons continue to work after the transition?
Your current user log-ons should continue to work after transition.

Will Providers need to purchase hardware to utilize the DDE system?
Providers who currently use the Remote system should not have to purchase any hardware for DDE. They will access DDE the same way they currently access Remote.

Why are we transitioning to FISS?
CMS chose FISS as the designated Medicare Part A processing system. To remain a Medicare contractor, all Fiscal Intermediaries must transition to FISS.

How many Part A Intermediaries are currently on FISS?
All Part A Intermediaries, with the exception of the current APASS users (Maine/Massachusetts, Rhode Island, New Hampshire/Vermont, Washington/Alaska, North Carolina) are on FISS. We are the first of the current APASS users to transition. Maine/Massachusetts will be the last APASS user to transition, and their transition date is currently scheduled for May 2004.

When will we receive training?
Providers who currently utilize the APASS Remote system will receive FISS Direct Data Entry (DDE) training. Training seminars will be scheduled in various locations throughout the United States during the months of March, April, and May 2003. All current Remote Providers will receive an invitation to a FISS training in their general area.

How is FISS different from APASS? Will claims process differently?
FISS is a real time system, which means that claims will process through the system on a continuous basis during the day. For example, if a claim suspends with an error, and an examiner fixes that error, the claim will immediately continue processing through the system-it does not have to wait for a batch cycle like it does on APASS. Claims will still process according to Medicare rules and regulations with the same result as they would get on APASS.

Do we still have to do HIPAA on FISS?
Yes. HIPAA is a federal mandate, regardless of processing system.

Page Last Updated: Tuesday, 15-Jul-2008 10:34:13 CDT