BACKGROUND

Providers requested an easier retrieval method for correcting their Returned to Provider (RTP) claims.

NEW PROCEDURE

The Direct Data Entry (DDE) system has been updated to allow the ability for the claim correction summary to sort in different ways. Providers have requested the ability to sort RTP claims with the following attributes:

• Alpha - sort by last name, first initial
• Reason code - sort in ascending reason code order
• Receipt date - sort in receipt date order, with the oldest date displaying first
• Type of Bill - only brings forward the selected bill type
• HIC# - sort by Health Insurance Claim Number (HIC#) in ascending order
• Medical Record Number - sort by Medical Record Number in ascending order

BILLING INSTRUCTIONS ----> Via the DDE Main Menu, access 03 Claims Correction.

-----> From the Claim and Attachment Correction Menu, choose any one of the following claim correction options, key in the desired option number and press <ENTER>.

----> Press <ENTER> again. FSS will display the claims in the TOB/RECEIVE DATE order.

On the Claim Summary Inquiry Screen, you will see a new field called "DDE Sort". The following is the new sort criteria:

-----> Key in the letter indicating the desired sort in the DDE SORT field and press <ENTER>.

Note: A new field called APROV/MRN@ appears on the header portion of the Claim Summary Screen. This new field permanently replaces the APROV@ field. When a selection other than TOB/RECEIVE DATE is selected, FSS will display the Medical Record Number of each claim in the APROV/MRN@ field.

----->Use the PF5 & PF6 keys to scroll to different pages

----->Place an "S" beside the desired claim to be corrected and press <ENTER>.

----->Correct the claim and PF9.

----->You will be taken back to the Claims Summary Screen.