DDE User's Guide

Effective July 1, 2019, when selecting ELGA, ELGH, HIQA or HIQH, a message will display before beneficiary eligibility information is made available. This message will notify you that beginning in the fall of 2019, the Centers for Medicare & Medicaid Services (CMS) plans to terminate access to ELGA, ELGH, HIQA and HIQH for those who already use the HIPAA Eligibility Transaction System (HETS). This will affect clearinghouses, third-party billers, providers and other users. You will need to press the "ENTER" key to acknowledge the message before eligibility information displays. If you use automation methods to obtain beneficiary eligibility information via ELGA, ELGH, HIQA and HIQH, you may need to modify your program in order to accept the message. Please review DDE Guide Section 2 more details of this change.
 
If you currently use both the CWF eligibility transactions and HETS to obtain Medicare beneficiary eligibility information, it is recommended that you begin using HETS exclusively. For additional information about HETS, refer to the HIPPA Eligibility Transaction System (HETS) Web page on the CMS website. Please contact your clearinghouse/vendor to notify them of this change, and ask if they offer the HETS application.

The Direct Data Entry (DDE) Online Remote Terminal Access was designed as an integral part of the Fiscal Intermediary Standard System (FISS) to give Medicare providers a direct access mechanism for answering questions about their claims. DDE users may perform the following functions electronically:

  • Submit UB-04 claims
  • Correct, adjust, and cancel claims
  • Perform inquiries such as beneficiary eligibility, claims history, revenue codes, diagnosis codes, etc.
  • View certain online reports

The DDE User's Guide has been separated into six sections. Please refer to the following sections for detailed information about using the DDE screens.

DDE User's Guide Section Overview

Section

Section Title

Descriptive Language

 1

 Introduction & Connectivity  This section introduces you to the Direct Data Entry (DDE) system, and provides a list of the most common acronyms as well navigational tips to include function keys, shortcuts, and common claim status and locations. This section also provides screen illustrations with instructions for signing on, the main menu display, signing off, and changing passwords.

2

 Checking Beneficiary Eligibility    This section explains how to access beneficiary eligibility information via the Common Working File (CWF) screens, Health Insurance Query Access (HIQA) and Health Insurance Query for HHAs (HIQH), to verify and ensure correct information is submitted on your Medicare claim. Screen examples and field descriptors are also provided.

3

 Inquiries (Main Menu Option 01)  This section provides screen illustrations and information about the inquiry options available in DDE, such as viewing inquiry screens to check the validity of diagnosis codes, revenue codes, and HCPCS codes, checking beneficiary/patient eligibility, check the status of claims, view Additional Development Requests (ADRs) letters, Medicare check history, and home health payment totals.

 4

 Claims & Attachments (Main Menu Option 02)   This section includes instructions, screen illustrations, and field descriptions on how to enter UB-04 claim information, including home health requests for anticipated payment (RAPs), hospice notice of elections (NOEs), and roster bill data entry. The MSP Payment Information screens are detailed in this section.

 5

 Claims Correction (Main Menu Option 03)   This section provides instructions, screen illustrations, and field descriptions on how to correct claims that are in the Return to Provider (RTP) file, adjust or cancel finalized claims.

 6

 Online Reports (Main Menu Option 04)  This section provides information on certain provider-specific reports that are available through the DDE system.

To access the DDE User's Guides, select the PDF links below.

Contact Palmetto GBA JM Part A Medicare


Provider Contact Center: 855-696-0705

Email Part A

Contact a specific JM Part A department

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

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