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FISS/DDE Provider Online Guide: Resources


How to Correct a Return to Provider Claim

To correct a RTP claim on the FISS/DDE Provider Online System, follow these steps:

Step Action
1 Select the CLAIMS CORRECTION (03) submenu from the MAIN MENU
2 Key the appropriate claims correction option number from the CLAIMS CORRECTION directory at the ENTER MENU SELECTION: prompt

Valid entries are:
21 – Inpatient
23 – Outpatient
25 – SNF
27 – Home Health
29 – Hospice
3 Press <Enter>
4 Select the RTP claims you wish to correct by performing any of the following claim selection methods:

  1. Enter the Medicare ID number (MID) and the dates of service of a specific claim that you wish to correct in the MID and FROM DATE/TO DATE fields and press <ENTER>

  2. Press <Enter> and a list of all RTP claims for the bill type selected will appear for the NPI identified

  3. Enter the appropriate DDE sort option code in the DDE SORT field

    Valid entries are:
    N – Sort by beneficiary last name;
    R – Sort in ascending reason code order;
    D – Sort in receipt date order
    Blank – Sort by type of bill (this is the default sort process
    H – Sort according to HIC # (ascending order); or,
    M – Sort according to medical record number (ascending) 

  4. Enter the appropriate Medical Review select option code in the MEDICAL REVIEW SELECT field. Please Note: The FISS/DDE sort option may not be available in all FISS regions.

    Valid entries are:
    Blank – Selects all claims
    1 – Selects all claims
    2 – Selects all claims excluding medical review
    3 – Selects only medical review claims
5 Select the claim you wish to update by placing a “U” next to the claim record under the SEL field
6 Press <Enter>
7 Make the necessary corrections based on the reason code(s) identified in the lower left-hand corner of the claim screen. Note: To view the narrative for the first reason code, press the <F1/PF1> help key. If there are subsequent reason codes, position your cursor anywhere underneath the reason code, and then press <F1/PF1> to view the narrative. To return to the claim record, press <F3/PF3>.
8 After all corrections have been made, <F9/PF9> key to store or update the claim

 

FISS/DDE Provider Online Guide: Resources - How to Correct a Return to Provider Claim
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