Direct Data Entry (DDE) Home Health
Contents
1. Palmetto GBA PARTNERS IN EXCELLENCE Cern File Edit Connection Setup Macro Window Help 8 90 mom o 2 TS00P420 TS00M42 Companion Data Services LLC 06 23 21 49 Type your userid and password ig SE Enter DDE User ID and Userid Pas NOE Password on this Screen Verify New Password gt Note Parts of this computer system may be owned by the United States Government If so the Centers for Medicare and Medicaid Services CMS maintains ownership and responsibility for those parts Users of this system must adhere to CMS Information Security Policies Standards and Procedures Any usage of this system may be monitored recorded and audited Any unauthorized use of this system is prohibited and subject to criminal and civil penalties Any use of this systems constitutes consent to any and all monitoring and recording of the user s activities 0 16 26 B Palmetto GBA PARTNERS IN EXCELLENCE e Edit Connection Setup Macro Window Help IDZH FO gt MOH enn Type HIQH on this Screen and Press Enter SIGN ON IS COMPLETE INVALID ATTEMPTS LAST ACCESS 16 45 17 06 22 2009 Palmetto GBA PARTNERS IN EXCELLENCE CLAIM NUMBER Enter Beneficiary HICN Medicare Number SURNAME I x Enter 1 6 letters of beneficiary last name INITIAL 2 Enter 15 initial of beneficiary first name DATE BIRTH2. 23 Palmetto GBA PARTNERS IN EXCELLENCE ge 2 Required Field Loc con t T CHARGE Total visit charge for th Determined by the provider Supply 0270 and 0623 Total charge for each Keep itemized statement in the chart Palmetto GBA PARTNERS IN EXCELLENCE 24 Palmetto GBA PARTNERS IN EXCELLENCE CARE A ONLINE SYSTEM CLAIM PAGE 0 UB04 CLAIM UPDATE S LOC S B0100 PROVIDER XXXXXXXXXX OFFSITE ZIPCD OSCAR RI AB PRIOR PAY EST AMT D XXXXXX YOY DUE FROM COST RPT DAYS NON COST RPT DAYS 4 5 9 END OF POA IND HOSPICE TERM ILL IND 5 TMENT REASON CODE REJECT CODE NONPAY CODE 000000000 LN XXXXXXXX FN MI 0000 A 1000 Palmetto GBA PARTNERS IN EXCELLENCE Release of Information cation Indicator ter Y under RI and AF 25 Palmetto GBA PARTNERS IN EXCELLENCE Last Name First Name I National Provider Identifier PHYS Other Physician Last Name Palmetto GBA PARTNERS IN EXCELLENCE ONLINE SYSTEM CLAIM ENTRY REMARK PAGE S LOC S PROVIDER to Palmetto GBA for anything unusual that you want the o know such as the reason for adjustment or cancellatio very important information from the claims departmi puocessing of your claim Medical Review may also us ason for denial 48 AMBULANCE 40 THERAPY 41 HOME HEALTH MED B E1 ESRD ATTACH Palmetto GBA PARTNERS IN EXCELLE
3. Enter beneficiary date of birth mmddyyyy SEX CODE Enter beneficiary sex M REQUESTOR ID Always a 1 PRINTER DEST To Not required leave blank INTER NO 00880 Palmetto GBA NPI INDICATOR N NPI or Blank PROVIDER NO H Enter 6 digit provider number HOST ID GL GW KS MA PA NE SE SO SW APP DATE Optional REASON CODE 31 Palmetto GBA PARTNERS IN EXCELLENCE amp CT ME MA SE South UNCONDITIONAL SCREEN ae CLEAR END Setup Mace SCREEN 9 10 mom 77 enn gt Ede seve SCREEN AA CUEAR END 7 11 Window Hep w SCREEN CLEAR ENO SCREEN G CLEAR END PF7 J 2 7 BO esa tr SET ve Tebet taedd 12 Palmetto GBA PARTNERS IN EXCELLENCE nderstanding DDE Basi Palmetto GBA PARTNERS IN EXCELLENCE ar screen Freezes hold down the and press the R key to reset the screer lays at the bottom of the screen when T 13 Palmetto GBA PARTNERS IN EXCELLENCE Function Keys Access reason code file From any claim page Exit a menu or Submenu Exit the Claim s Sys C tem Palmetto GBA PARTNE
4. 2 PALM HARBOR FL 4 6 ADMIT DATE 073106 HR 00 TYPE SRC 1 D HM 03 04 05 06 07 08 09 10 03 04 05 08 09 10 02 03 06 07 10 MSP APP IND 69 Palmetto GBA PARTNERS IN EXCELLENCE D Codes to Correct HIC number or ovider number ancel to repay a Duplicate or OIG Palmetto GBA PARTNERS IN EXCELLENCE 2 Of Claim For Cancel ue Codes and Charges Page t do anything to this page because elling the entire claim anyway table Cancellation Condition C 70 Palmetto GBA PARTNERS IN EXCELLENCE DICARE A ONLINE SYSTEM CLAIM PAGE 0 CLAIM ADJUSTMENT 337 5 10 S B0100 PROVIDER XXXXXX OFFSITE ZIPCD OSCAR PRIOR PAY EST AMT PROV 0 00 0 00 0 00 0 00 0 00 00000000000000 COST RPT DAYS NON COST RPT DA 2 45932 3 4280 4 72887 5 V1302 7 8 9 HOSPICE TERM ILL IND NONPAY CODE 1 Palmetto GBA PARTNERS IN EXCELLENCE ED T CARE A ONLINE SYSTEM CLAIM PA CLAIM ADJUSTMENT REMARK PAGE 01 338 S LOC S B0100 PROVIDER XXXXXX RESUBMIT WITH CORRECT SOC DATES 41 HOME HEALTH 71 Palmetto GBA PARTNERS IN EXCELLENCE gt Send The Cancelled Palmetto GBA PARTNERS IN EXCELLENCE Cancel Claims ondition Code D5 or D6 on claim page djustment reason code OT on claim pa marks on page 4 72 Palmetto GBA PARTNERS IN EXCELLENCE More About DDE Palmetto GBA PARTNERS IN EXCELLENCE More about DDE different
5. 03 06 07 10 AMOUNTS ANS MSP APP IND 63 Palmetto GBA PARTNERS IN EXCELLENCE ptable Adjustment Condition Codes anges to Service Dates hanges to Charges Note Takes ecedence if multiple changes are be lade in addition to changes in charge hanges to Revenue HCPCS and HIPI Palmetto GBA PARTNERS IN EXCELLENCE UB04 CLAIM ADJUSTMENT 337 S LOC S B0100 PROVIDER TOT cov UNIT UNIT TOT CHARGE NCOV CHARGE SERV 00060 00060 1828 31 00006 00006 106 36 00003 00003 106 36 00003 00003 106 36 00003 00003 106 36 00003 00003 106 36 00003 00003 106 36 00002 00002 106 36 00003 00003 97 28 00003 00003 97 28 00003 00003 97 28 000 64 Palmetto GBA PARTNERS IN EXCELLENCE y the Corrections instructions cover presentation Palmetto GBA PARTNERS IN EXCELLENCE meer CARE A ONLINE SYSTEM CLAIM P CLAIM ADJUSTMENT 337 S LOC S B0100 PROVIDER XXXXXX OFFSITE ZIPCD OSCAR RI AB PRIOR PAY EST AMT PROV IY 0 00 0 00 0 00 0 00 0 00 0000000000000000 COST RPT DAYS NON COST RPT DAYS 9190 2 45932 3 4280 4 72887 5 V1302 7 8 9 E CODE HOSPICE TERM ILL IND ONPAY CODE 65 Palmetto GBA PARTNERS IN EXCELLENCE MEDICARE A ONLINE SYSTEM CLAIM PAGE CLAIM ADJUSTMENT REMARK PAGE 01 TOB 337 8 10 S B0100 PROVIDER XXXXXX ADD NURSING VISIT ON 9 24 06 7 48 AMBULANCE 40 THERAPY 41 HOME HEALTH IE El ESRD H Palmetto GBA PA
6. TOT CHG PROV REIMB PD DT CAN DT REAS NPC Palmetto GBA PARTNERS IN EXCELLENCE I C A R E AmO N LE INTES YA SEM CLAIM SUMMARY INQUIRY NPI PROVIDER Number S LOC T B9997 TOB FROM DATE 010106 TO DATE DDE SORT PROV MRN S LOC TOB ADM DT FRM D ST INIT TOT CHG T B9997 090504 082606 102406 758 03 103006 38107 T B9997 102706 102706 102706 110306 19203 T B9997 082106 082106 082106 110606 31300 Palmetto GBA PARTNERS IN EXCELLENCE 5 CLAIM INQUIRY 329 S LOC P B9997 OSCAR PROV HOSP PROV PROCESS NEW HIC 000000000000000 FED TAX NO 000000000 TAX SUB 0106 TO 120106 DAYS COV N C co FIRST XXXXX MI X DOB MMDDY 2 COLUMBIA SC 4 6 ADMIT DATE 073106 HR 00 TYPE SRC 1 D HM 03 04 05 06 07 08 09 10 02 03 04 05 07 08 09 10 02 06 10 38 Palmetto GBA PARTNERS IN EXCELLENCE Requests ADR S see the total number of claims in and enter SB60 a ye Wi Snow tne TC Palmetto GBA PARTNERS IN EXCELLENCE Monitor ADRs Via DDE iew individual claims in ADR status t Main Menu select 01 for inquiry ct 12 for claims sub menu ab to the S LOC field and enter SB600 view print ADR letter select the clair 39 Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GOVT BENEFITS ADMINISTRATORS INQUIRY MENU SUB MENU HCPC CODES DX PROC CODES ADJUSTMENT REASON CO ES REASON CODES ANSI REASON CODES ZIP Code File Palmetto
7. page rward ursor on claim page type page numk red press enter payment e Code 17 and an amount on page one Cid LECL 73 Palmetto GBA PARTNERS IN EXCELLENCE More about DDE lowncode of a claim Page 2 of your claim s the F11 key PPS code billed will be shown along with PPS code resulting in payment nent Control Number DCN ited on processed DDE claims Palmetto GBA PARTNERS IN EXCELLENCE More about DDE 01 Inquiries 12 Claims it work for you r One or all fields or a combination one status S T P or a S LOC sw ember delete 3x s in TOB field before 74 Palmetto GBA PARTNERS IN EXCELLENCE 75
8. F 25 HOME HEALTH 26 HOSPICE 29 CLAIM ADJUSTMENTS CANCELS INPATIENT 30 OUTPATIENT 31 SNF 32 HOME HEALTH 33 HOSPICE 35 ATTACHMENTS PACEMAKER 42 AMBULANCE 43 Y Palmetto GBA PARTNERS IN EXCELLENCE MEND I CARE A ONLINE SYSTEM CLAIM SUMMARY INQUIRY NPI PROVIDER XXXXXX S LOG T B9997 TOB FROM DATE XXX TO DATE XXX DDE SOR PROV MRN S LOC TOB ADM DT FRM DT THRU DT FIRST INIT TOT CHG PROV REIMB PD DT CAN DT REAS NPC T status Palmetto GBA PARTNERS IN EXCELLENCE EDIT CARE A ONLINE SYSTEM CLAIM SUMMARY INQUIRY NPI PROVIDER XXXXXX S LOC T B9997 TE 092906 TO DATE 092906 DDE SORT CT PROV MRN 5 10 ADM DT FRM DT THRU DT ST INIT TOT CHG PROV REIMB PD DT DT REAS NPC T B9997 322 073106 092906 092906 10 101006 W7A01 E OF OPTION 1 One Medicare Number at a Time 50 Palmetto GBA PARTNERS IN EXCELLENCE DICARE A ONLINE SYSTEM CLAIM SUMMARY INQUIRY NPI OSCAR S LOC T B9997 M DATE TO DATE DDE SORT CT PROV MRN 5 10 ADM DT FRM DT THRU DT REC IST INIT TOT CHG PROV REIMB PD DT DT REAS NPC 0 T B9997 322 100906 100906 100906 1 T 103006 7273 T B9997 329 090504 082606 102406 758 03 103006 38107 T B9997 322 102706 102706 102706 110306 19203 T B9997 082106 082106 082106 110606 31300 Palmetto GBA PARTNERS IN EXCELLENCE EDICARE A ONLINE SYSTEM UB04 CLAIM UPDATE 322 S LOC T B9997 OSCAR PROV HOSP
9. GBA PARTNERS IN EXCELLENCE MEDICARE A ONLINE SYSTEM CLAIM SUMMARY TOTALS INQUIRY S LOC CAT CLAIM COUNT TOTAL CHARGES TOTAL PAYMENT 71 451 77 18 795 34 00 00 1 985 58 7 925 00 18 795 34 3 450 00 9 75179 4 475 00 9 043 55 1 725 00 00 00 1 725 00 00 00 00 00 00 00 6 925 00 00 00 00 00 00 00 6 925 4 050 4 050 A N S Palmetto GBA PARTNERS IN EXCELLENCE Categories and Total of all categories all S LOC Count within each Status Loc stments within each Status Loc edical Policy RTPs where first digit of reason code is a 5 n Medical RTPs where first digit of tl Ey Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GOVT BENEFITS ADMINISTRATORS INQUIRY MENU SUB MENU HCPC CODES DX PROC CODES ADJUSTMENT REASON CODES REASON CODES ANSI REASON CODES ZIP Code File 41 Palmetto GBA PARTNERS EXCELLENCE CHECK HISTORY PROV XXXXXX CHECK DATE EFT XXXXXXX 061103 XXXXXXX 061031 EFT XXXXXXX 061027 Palmetto GBA PARTNERS IN EXCELLENCE NPI 0000000000 AMOUNT 1 083 81 9 922 96 5 911 01 EDI CARE SY ST EM CHECK HISTORY PROV XXXXXX CHECK DATE 001531XXXX 061102 001531XXXX 061101 001530XXXX 061027 NPI 0000000000 AMOUNT 3 307 04 849 55 1 379 28 42 Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GOVT BENEFITS ADMINISTRATORS INQUIRY MENU SUB MENU
10. HCPC CODES DX PROC CODES ADJUSTMENT REASON CODES REASON CODES ANSI REASON CODES ZIP Code File Palmetto GBA PARTNERS IN EXCELLENCE HCPC Codes Code to receive a description a reimbursement rate based on n of your computer ss F11 key 43 Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GOVT BENEFITS ADMINISTRATORS INQUIRY MENU SUB MENU HCPC CODES DX PROC CODES ADJUSTMENT REASON CODES REASON CODES ANSI REASON CODES ZIP Code File Palmetto GBA PARTNERS IN EXCELLENCE correct current code F6 to view more codes 44 Palmetto GBA PARTNERS IN EXCELLENCE moet CARE A ONLINE SYSTEM ICD 9 CM CODE INQUIRY V581 DESCRIPTION ICE CHEMOTHERAPY 093008 093009 RAPY ENCOUNTER 093009 RANSFUSION NO DX 093009 URG DRESSNG SUTUR 093009 Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GOVT BENEFITS ADMINISTRATORS INQUIRY MENU SUB MENU HCPC CODES DX PROC CODES ADJUSTMENT REASON CODE REASON CODES ANSI REASON CODES ZIP Code File 45 Palmetto GBA PARTNERS IN EXCELLENCE EDICARE A ONLINE SYSTEM OP REASON CODES INQUIRY DT MSN EFF TERM EMC HC PRO REAS DATE DATE ST LOC ST LOC HD CPY A B NB ADR CAL DY NARRATIVE Palmetto GBA PARTNERS IN EXCELLENCE REASON CODES INQUIRY MSN EFF TERM EMC DATE REAS DATE DATE ST LOC ST LOC LOC 030194 S MMIL2 S MMIL2 HD CPY A B NB ADR CAL DY NG FIELDS ON THE FINAL
11. IN MENU FOR REGION A6504A9P INQUIRIES CLAIMS ATTACHMENTS CLAIMS CORRECTION ONLINE REPORTS VIEW 61 Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GOVT BENEFITS ADMINISTRATORS CLAIM AND ATTACHMENTS CORRECTION MENU CLAIMS CORRECTION INPATIENT 21 OUTPATIENT 23 SNF 25 HOME HEALTH 27 HOSPICE 29 CLAIM ADJUSTMENTS CANCELS INPATIENT 30 OUTPATIENT 31 SNF 32 HOME HEALTH 33 HOSPICE 35 ATTACHMENTS PACEMAKER 42 AMBULANCE 43 Y 4 Palmetto GBA PARTNERS IN EXCELLENCE MEDICARE ONLINE SYSTEM CLAIM SUMMARY INQUIRY NPI PROVIDER XXXXXX FROM DATE TO DATE SORT PROV MRN S LOC TOB ADM DT THRU FIRST INIT TOT CHG PROV REIMB PD DT DT REAS NP Palmetto GBA PARTNERS IN EXCELLENCE SY S TEM CLAIM SUMMARY INQUIRY NPI PROVIDER S LOC P TOI FROM DATE TO DATE DDE SOR ELECT PROV MRN S LOC TOB ADM DT FRM DT THRU DT ST INIT TOT CHG PROV REIMB PD DT DT REAS NPC x P B9997 339 073106 073106 092806 I 2813 09 1828 31 102406 37186 Palmetto GBA PARTNERS IN EXCELLENCE ICARE A ONLINE SYSTEM UB04 CLAIM ADJUSTMENT 327 S LOC S B0100 OSCAR PROV HOSP PROV PROCESS NEW HIC 0000000000000 FED TAX NO 000000000 TAX SUB 06 TO 092806 DAYS COV 031 N C co LTR FIRST JOHN MI F DOB MMDDYYYY N 2 PALM HARBOR FL 4 6 ADMIT DATE 073106 HR 00 TYPE SRC 1 D HM 03 04 05 06 07 08 09 10 02 03 04 05 07 08 09 10 02
12. NCE CARE ONLINE SYSTEM CLAIM ENTRY OB 329 S LOC S PROVIDER XXXXXXXXXX CLAIM PAGE 0 CERT SSN HIC SEX GROUP NAME DOB INS GROUP NUMBER Palmetto GBA PARTNERS IN EXCELLENCE oty 1 claim page will appear for yo 31M 27 Palmetto GBA PARTNERS IN EXCELLENCE a Claims Entry ur claim does not transmit after Palmetto GBA PARTNERS IN EXCELLENCE 28 Palmetto GBA PARTNERS IN EXCELLENCE Key Points RAP t Status is always 30 on line page 2 of claim revenue code Palmetto GBA PARTNERS IN EXCELLENCE n and To date is the first date of the ne 29 Palmetto GBA PARTNERS IN EXCELLENCE le Health MSP final claims can longe red corrected or adjusted through DD Palmetto GBA PARTNERS IN EXCELLENCE 30 Palmetto GBA PARTNERS IN EXCELLENCE Palmetto GBA PARTNERS IN EXCELLENCE Claim Inquiries 31 Palmetto GBA PARTNERS IN EXCELLENCE 3 you what you can or cannot do to the ts you to delays in reimbursement Palmetto GBA PARTNERS IN EXCELLENCE Status Location S LOC T B9997 ition is Claims Current Status us Claim needs corrections Position is the Claim Processing Type claim is batch electronic edical review may be processing 32 Palmetto GBA PARTNERS IN EXCELLENCE a Palmetto GBA PARTNERS IN EXCELLENCE Status Descriptions itus means the claim is completel ed can be cancel
13. PROV PROCESS NEW HIC 000000000000000 FED TAX NO 000000000 TAX SUB 906 TO 092906 DAYS COV N C FIRST XXXXX JLOGY CIRCLE 2 COLUMBIA SC 4 6 ADMIT DATE 073106 HR 00 TYPE SRC 1 D HM 03 04 05 06 07 08 09 02 03 04 05 07 08 09 10 02 03 06 07 10 AMOUNTS ANSI MSP APP IND Palmetto GBA PARTNERS IN EXCELLENCE Look Up Reason Code om any Claim Page is a fast track to sub category 17 R matically displays the first reason ttom of your claim page Palmetto GBA PARTNERS IN EXCELLENCE Merc A RUE A ONLINE SYSTEM OP UB03 REASON CODES INQUIRY DT 040704 MSN HC PRO REAS DATE DATE ST LOC ST LOC LOC T S M1501 HD CPY A B NB ADR CAL DY NARRATIVE OF OCE HAS DETECTED AN ERROR IN THE 1ST DIAGNOSIS CODE 52 Palmetto GBA PARTNERS IN EXCELLENCE F3 Back To The Clai Palmetto GBA PARTNERS IN EXCELLENCE UEC A R NME so Yo T EM CLAIM PAGE UB04 CLAIM UPDATE 322 S LOC T B9997 PROVIDER xxxxxx OFFSITE ZIPCD OSCAR PRIOR PAY EST PROV 0 00 0 00 0 00 0 00 0 00 00000000000000 COST RPT DAYS NON COST RPT DA 5830 2 9190 3 45932 4 4280 5 72887 1302 7 8 9 E CODE HOSPICE TERM ILL IND DATES 1 5 REASON CODE REJECT CODE 53 Palmetto GBA PARTNERS IN EXCELLENCE Sub Category p left corner of every claim page kofitasa Short Cut ur Cursor next to SC e any 2 numbers from the Inqui
14. Palmetto GBA PARTNERS IN EXCELLENCE to retrieve the handout fo presentation Catalog from the top menu when you first sign ning section of the Palmetto GBA Web site A Home Health under the Category head the handout same name as the course checkmark in the box next to the handout and Palmetto GBA PARTNERS IN EXCELLENCE Direct Data Entry DDE Home Health Palmetto GBA PARTNERS IN EXCELLENCE erstanding DDE Basics m Entry Palmetto GBA PARTNERS IN EXCELLENCE Palmetto GBA PARTNERS IN EXCELLENCE Palmetto GBA PARTNERS IN EXCELLENCE the Fiscal Intermediary Standarc It gives Medicare providers dire to information on their claims Palmetto GBA PARTNERS IN EXCELLENCE Direct Data Entry and Submit Claims st Adjust and Cancel Claims about Beneficiary lation Eligibility Palmetto GBA PARTNERS IN EXCELLENCE Direct Data Entry other possible insurances HMO e H and or HIQA claims for payment errors ADR outlier payments Palmetto GBA PARTNERS IN EXCELLENCE References Palmetto GBA PARTNERS IN EXCELLENCE Direct Data Entry DDE User s Man icare Part A Palmetto GBA PARTNERS IN EXCELLENCE Instructions s hhs gov manuals act Internet Only Manuals Claims Processing Manual CMS b ch 10 Claims Processing Manual CMS Pul Palmetto GBA PARTNERS IN EXCELLENCE Eligibility
15. RS IN EXCELLENCE Function Keys Scroll Forward in a Screen Pa View Previous Page Page Forward SE and Ente 14 Palmetto GBA PARTNERS IN EXCELLENCE Claims Entry Palmetto GBA PARTNERS IN EXCELLENCE Claims Entry lames within the DDE system follow the same order as the UB 15 Palmetto GBA PARTNERS IN EXCELLENCE laims Entry Patient Information Revenue HCPCS Codes and Ch Palmetto GBA PARTNERS IN EXCELLENCE DDE Main Menu 16 Syscase Reflection BIS 7D DE INVALID ATTEMPTS LA RO E Fie Edt Connection Setup Macro Window Hep D 00 FSS0 zero Here 17 Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GBA MAIN MENU FOR REGION A6504A9P INQUIRIES CLAIMS ATTACHMENTS CLAIMS CORRECTION ONLINE REPORTS VIEW Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GBA CLAIM AND ATTACHMENTS ENTRY MENU CLAIMS ENTRY INPATIENT 20 OUTPATIEN 22 SNF 24 HOME HEALTH 26 HOSPICE 28 NOE 49 ROSTER BILL ENTRY 87 ATTACHMENT ENTRY HOME HEALTH 41 DME HISTORY 54 ESRD CMS 382 FORM 57 18 Palmetto GBA PARTNERS IN EXCELLENCE CLAIM ENTRY TOB S LOC S OSCAR TRANSFERING HOSPICE PROVIDER TAX SUB DAYS COV N C FIRST MI ADMIT DATE HR TYPE SRC D HM 04 05 06 FAC ZIP ANSI MSP APP IND 3 Palmetto GBA PARTNERS IN E
16. RTNERS IN EXCELLENCE send The Adjusted 66 Palmetto GBA PARTNERS IN EXCELLENCE Cancellations Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GBA MAIN MENU FOR REGION A6504A9P INQUIRIES CLAIMS ATTACHMENTS CLAIMS CORRECTION ONLINE REPORTS VIEW 67 Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GOVT BENEFITS ADMINISTRATORS CLAIM AND ATTACHMENTS CORRECTION MENU CLAIMS CORRECTION INPATIENT 21 OUTPATIENT 23 SNF 25 HOME HEALTH 27 HOSPICE 29 CLAIM ADJUSTMENTS CANCELS INPATIENT 30 OUTPATIENT 31 SNF 32 HOME HEALTH 33 HOSPICE 35 ATTACHMENTS PACEMAKER 42 AMBULANCE 43 Y 4 Palmetto GBA PARTNERS IN EXCELLENCE MEDICARE ONLINE SYSTEM CLAIM SUMMARY INQUIRY NPI PROVIDER XXXXXX S LOC FROM DATE TO DATE DDE SORT SELECT PROV MRN S LOC TOB ADM DT FRM DT THRU DT FIRST INIT TOT CHG PROV REIMB PD DT CAN DT REAS NI 68 Palmetto GBA PARTNERS IN EXCELLENCE EDICARE A ONLINE SYSTEM CLAIM SUMMARY INQUIRY NPI PROVIDER XXXXXX S LOC P 1 FROM DATE TO DATE LECT PROV MRN 5 10 TOB ADM DT FRM DT THRU DT IST INIT TOT CHG PROV REIMB PD DT DT REAS NPC X P B9997 339 073106 073106 092806 2813 09 1828 31 102406 37186 Palmetto GBA PARTNERS IN EXCELLENCE CLAIM ADJUSTMENT B 338 S LOC S B0100 OSCAR PROV HOSP PROV PROCESS NEW HIC 000000000000000 FED TAX NO 000000000 TAX SUB 106 TO 092806 DAYS COV 031 co LTR FIRST JOHN MI F DOB MMDDYYYY
17. TOB 329 OR 339 DO NOT MATCH DATE 46 Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GOVT BENEFITS ADMINISTRATORS INQUIRY MENU SUB MENU HCPC CODES DX PROC CODES ADJUSTMENT REASON CODES REASON CODES ANSI REASON CODES ZIP Code File Palmetto GBA PARTNERS IN EXCELLENCE erican National Standar Institute an press enter and it will show a gt n codes if you are not looking fo 47 Palmetto GBA PARTNERS IN EXCELLENCE END IT CG A RE A SY S TEM ANSI STANDARD CODES INQUIRY SELECTION SCREEN GROUPS R REMARKS A APPEALS T lt CLAIM CATEGORY 8 CLAIM STATUS NARRATIVE EFUND AMOUNT ENIED CHARGES AL ADJUSTMENT CONDARY PAYER PATIENT LIABILITY MET Y CLAIM PPS CAPITAL OUTLIER AMOUNT ST CLAIM PPS CAPITAL OUTLIER AMOUNT TALIZATION OR 30 DAY TRANSFER REQUIREMENT NOT MET PAYMENT ADJUSTMENT D UNGROUPABLE DRG D VISITS UNT HAS BEEN REDUCED BECAUSE A COMPONENT OF THE BASI ERVICE HAS BEEN TRANSFERRED TO THE PROPER PAYER PROC Palmetto PARTNERS IN EXCELLENCE Corrections To Provider for Corr RTPs 48 Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GBA MAIN MENU FOR REGION A6504A9P 01 INQUIRIES CLAIMS ATTACHMENTS CLAIMS CORRECTION ONLINE REPORTS VIEW Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GOVT BENEFITS ADMINISTRATORS CLAIM AND ATTACHMENTS CORRECTION MENU CLAIMS CORRECTION INPATIENT 21 OUTPATIENT 23 SN
18. XCELLENCE N Medicare Number Type of Bill 19 Palmetto GBA PARTNERS IN EXCELLENCE T Beneficiary s Last Name IST Beneficiary s First Name DR 1 Street Address DR 2 City and State Beneficiary ZIP Code Palmetto GBA PARTNERS IN EXCELLENCE P Facility Zip Code CODES 20 Palmetto GBA PARTNERS IN EXCELLENCE DICARE A ONLINE SYSTEM CLAIM PAGE 0 UB04 CLAIM ENTRY REV CD PAGE 01 XXX S LOC S B0100 PROVIDER XXXXXXXXXX TOT cov RATE UNIT UNIT TOT CHARGE NCOV CHARGE SERV DT Palmetto GBA PARTNERS IN EXCELLENCE DICARE A ONLINE SYSTEM CLAIM PAGE 02 UB04 CLAIM INQUIRY REV CD PAGE 01 329 S LOC S B0100 PROVIDER XXXXXXXXXX cov UNIT TOT CHARGE NCOV CHARGE SERV DT 60 101206 150 00 101206 150 101606 150 101806 150 102006 150 102406 150 102606 150 101406 150 101606 150 101806 150 102006 150 102306 AA BOBOR OR AAA A AAA RARRAR AR A 21 Palmetto GBA PARTNERS IN EXCELLENCE Rev Cd 0421 0 Rev Cd 0431 0 Rev Cd 0441 0 Rev Cd 0551 0 Rev Cd 0561 0 Rev Cd 0571 0 Palmetto GBA PARTNERS IN EXCELLENCE Revenue Codes con t equent lines 2 3 4 etc Revenue Reminder 22 Palmetto GBA PARTNERS IN EXCELLENCE HCPC G0181 HCPC G0152 HCPC G0153 5 0154 MSW 0155 Palmetto GBA PARTNERS IN EXCELLENCE ample for care revenue codes l unit 15 minutes of care
19. cted claim has returned to the Medicare c tem im does NOT transmit heck reason codes bottom left of claim Palmetto GBA PARTNERS IN EXCELLENCE Corrections Summary 03 Corrections from main menu 21 Home Health 7 will appear in the S LOC field enter one Medicare number OR field blank eld blank allows you to p AUS 58 Palmetto GBA PARTNERS IN EXCELLENCE Corrections Summary sure PTAN NPI is present rer to TOB and hit the delete ke jwn and type an 5 next to the o select and correct Palmetto GBA PARTNERS IN EXCELLENCE Corrections Summary he correction s is made F9 to u slaim is fixed it will go 11 now be able to enter another N ar OR select the next claim eds corrected claim is not fixed you will be give 59 Palmetto GBA PARTNERS IN EXCELLENCE ecting a wrong Med Number HIC Palmetto GBA PARTNERS IN EXCELLENCE ICARE A ONLINE SYSTEM CLAIM PAGE CLAIM INQUIRY SV TOB 322 S LOC T B9997 OSCAR PROV HOSP PROV PROCESS NEW HIC Y 000000000000000 FED TAX NO 000000000 TAX SUB 00106 100106 DAYS COV N C co LTR FIRST JOHN MI F DOB MMDDYYYY 19 N 2 PALM HARBOR FL 4 6 ADMIT DATE 073106 HR 00 TYPE SRC 1 D HM 03 04 05 06 07 08 09 02 03 04 05 08 09 02 06 10 AMOUNTS ANSI MSP APP IND 60 Palmetto GBA PARTNERS IN EXCELLENCE Adjustments Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GBA MA
20. led l claim can be adjusted or cancelled cancelled RAP TOB 328 can be re s atus means the claim is complete carl an daniad hu mad al ratr 33 Palmetto GBA PARTNERS IN EXCELLENCE Status Descriptions latus means the claim is com gt ssed and was rejected k at the reason code on rejec resubmit a NEW claim WITH cor d from the reason code Palmetto GBA PARTNERS IN EXCELLENCE Status Descriptions itus RTP means submit a new claim 34 Palmetto GBA PARTNERS IN EXCELLENCE Status Descriptions itus means the Intermediary has e rated OR specially processed you Ps more than 60 days old and suppress moved to an I B9997 status for 3 yrs tl Palmetto GBA PARTNERS IN EXCELLENCE 35 Palmetto GBA PARTNERS IN EXCELLENCE Zlaims ready to go to a Common Working Fil Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GBA MAIN MENU FOR REGION A6504A9P INQUIRIES CLAIMS ATTACHMENTS CLAIMS CORRECTION ONLINE REPORTS VIEW 36 Palmetto GBA PARTNERS IN EXCELLENCE PALMETTO GOVT BENEFITS ADMINISTRATORS INQUIRY MENU SUB MENU HCPC CODES DX PROC CODES ADJUSTMENT REASON CO REASON CODES ANSI REASON CODES ZIP Code File Palmetto GBA PARTNERS IN EXCELLENCE EDICARE A ONLINE SYSTEM CLAIM SUMMARY INQUIRY NPI PROVIDER S LOC TOB X FROM DATE TO DATE DDE SORT CT PROV MRN 5 10 TOB ADM DT FRM DT THRU DT ST INIT
21. ries sul Palmetto GBA PARTNERS IN EXCELLENCE Sub Category lally useful when making correcti ble the wrong ICD 9 code and Enter a correct ICD 9 code 54 Palmetto GBA PARTNERS IN EXCELLENCE in also see how valuable F3 k 56 it it allows Eh ki to eeraa ba z Palmetto GBA TNERS IN EXCELLENCE 55 Palmetto GBA PARTNERS IN EXCELLENCE UB04 CLAIM INQUIRY TOB 329 S LOC T B9997 PROVIDER XXXXXXXXXX TOT RATE UNIT UNIT TOT CHARGE NCOV CHARGE SERV D 60 o 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 Palmetto GBA PARTNERS IN EXCELLENCE ount on Revenue Code line 0001 A c ak a far A 56 Palmetto GBA PARTNERS IN EXCELLENCE o Add a Revenue Code Lit to the line below the total line 0001 Re he new Revenue Code information HOME to go to the Page Number fiele R The system will resort the Revenue merical order Palmetto GBA PARTNERS IN EXCELLENCE Line to the line to be changed and type the 1 e first position of the Revenue Code HOME to go to the Page Number field R The line will be deleted o the line below the total line 0001 Re he new Revenue Code information E to go to the Page Number fiel LLOC L Wi JLU L em ri the 57 Palmetto GBA PARTNERS IN EXCELLENCE Now What claim once you are completely fl Our corrections cess Completed Enter Next Data Or e
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