What is that you ask? The technical answer is the ‘Direct Data Entry’ System, otherwise known as the system which allows providers to verify eligibility, check on claims status (whether it’s paid, denied or pending), confirm payment information, access CPT and HCPC codes, and more. The information in the database is populated by providers entering claims data and then updated by Medicare contractors to include any subsequent actions taken that affect that claim. The DDE is maintained daily and can confirm patient information as soon as three days after a claims submission – a mere miracle in the healthcare industry.

Even more technical, the DDE outbound/Inbound claims status request and response, or ASC X12 277/276, is translated under the status screens in a system which most would refer to as “archaic”, but I love it. That black screen with green letters holds a wealth of information and can make or break a claim.

Gaining Access to the DDE

To access the DDE you must contract with a vendor that supports this service, such as Ability and eSolutions to name a couple. If you are not familiar with the DDE or have not yet registered and are an Institutional provider, I urge you to do so.

Here are a few reasons why:

  • Gain access to an incredibly fast and efficient way to check up on submitted claims. I find that within three days (often shorter) after claim submission, I can check to make sure that claim is on file and on track to be paid.
  • Medicare processes the claims in clearly defined steps or what they call “payment floors”. When a claim is first received, it is in “suspense”, then it will move to either paid, denied, or rejected. Where else can you check up on this info in real time?
  • The DDE also provides line item detail to exactly why and how the claim was paid or rejected. I recommend that you use this information to inform your future claims so you can avoid denials in the first place.
  • You are able to view the last 3 payment amounts and their EFT numbers.
  • Correcting and adjusting claims online is easy. Update your claims right from the DDE and in the case they still aren’t right, the system will tell you instantly. After that, the claim is immediately updated for the MAC to process – no more wasted time waiting for feedback on your claims.

You’ve Got a Friend in the DDE

The Direct Data Entry System is there to be your friend – and quite a reliable one too if I don’t say so myself. We all know that between sending claims out through our clearing houses and receiving a response back via an electronic explanation of benefits wastes time – plus we often aren’t given enough information to take action on. Luckily, with the DDE I know I can log in, search for a claim, get a real concrete answer as to why it was denied or rejected, and then quickly form a resolution from there.

Have something you’d like to add? Let me know your favorite part of the DDE system in the comments below!

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