What is Medicare Fiss?


What is Medicare Fiss?

The Fiscal Intermediary Standard System (FISS) is the standard Medicare Part A claims processing system. Through its Direct Data Entry (DDE) system you may perform the following functions: Enter, correct, adjust, or cancel your Medicare billing transactions. Inquire about beneficiary eligibility.

What is DDE Medicare?

The Direct Data Entry (DDE) system was designed as an integral part of the Fiscal Intermediary Standard System (FISS) to be used by all Medicare A providers. DDE will offer various tools to help providers obtain answers to many questions without contacting Medicare Part A via telephone or written inquiry.

How do I get access to Fiss?

If not already enrolled, complete an EDI enrollment form prior to completing the FISS application. Once the EDI enrollment form is processed, you will receive a letter confirming your enrollment. At that time, you can complete the FISS application for access.

How do I get access to DDE?

To access DDE, a request must be submitted electronically by the Authorized Signer using the DDE Electronic Access Request Form. Each facility will have an Authorized Signer. The DDE Authorized Signer is determined by the facility.

What is a DDE system?

DDE is a real-time Fiscal Intermediary Shared System (FISS) application giving providers interactive access for inquiries, claims entry and correction purposes. Functions include: Eligibility. Claims: Submission, Status, Corrections, Cancellations, Related Attachments and Roster Billing.

How do I correct a rejected Medicare claim?

When a claim is denied because the information submitted was incorrect, often the claim can be reopened using a Clerical Error Reopening (CER). CERs can be used to fix errors resulting from human or mechanical errors on the part of the party or the contractor.

How do I get DDE access?

What is a DDE form?

How do you suppress a claim in DDE?

Type a ‘Y’ in the SV (short cut) field located in the upper right hand corner of page 1 and then press [F9].

How do I adjust a paid claim in DDE?

1. To adjust paid or rejected claims, enter the Claims Adjustments option (21,23, or 25) that matches your provider type and press Enter.

Can you correct a rejected claim in DDE?

How do I reverse a Medicare claim?

In the event that you have charged incorrect items or submitted the claim against a different patient in error, you should contact Medicare’s eBusiness Service Centre on 1800 700 199 as soon as possible and ask that they cancel the claim on their end.

Which health insurance denies the most claims?

In its most recent report from 2013, the association found Medicare most frequently denied claims, at 4.92 percent of the time; followed by Aetna, with a denial rate of 1.5 percent; United Healthcare, 1.18 percent; and Cigna, 0.54 percent.