Answer:
Direct Data Entry (DDE) providers may view Reason Codes when correcting RTP claims. Reason Codes will appear at the bottom of the screen to explain why the claim was returned. From the Claim Summary Screen, select the claim to be corrected by tabbing to the 'SEL' field for the first line of the claim to be corrected. Type a 'U' or 'S' and press [ENTER]. The beneficiary's original UB-04 claim will display. Reason Codes will appear at the bottom of the screen to explain why the claim was returned. Press [F1] to access the Reason Code file. The system automatically pulls up the first reason code with its message. The message will identify the fields that are in error and will suggest corrective action. Press [F3] to return to the claim, or type in an additional reason code and press [ENTER].

For further information go to the DDE User's Guide.

Contact Palmetto GBA JJ Part A Medicare

Provider Contact Center: 877-567-7271

Email JJ Part A

Contact a specific JJ Part A department


Click to Chat Now