Direct data entry is critical under the UB-04.

Is your nursing home losing its touch with direct data entry (DDE)?

Many long-term care facilities that do batch billing using commercial software products have let their access to the Fiscal Intermediary Standard System (FISS)--and their ability to do DDE--expire, notes Theresa Lang, RN, BSN, WCC, RAC-C, senior health services consultant for Specialized Medical Services, Inc., in Milwaukee.

The UB-04 billing form has officially replaced the UB-92, and mandatory use of it begins May 23. One of the biggest implementation issues that skilled nursing facilities (SNF) must resolve is whether the commercial software products they use to batch their claims will be ready to use the UB-04, says Lang.

DDE access will provide SNFs with a backup plan for manual entry in case commercial software products aren't ready, she notes. "My guess is that a lot of providers will have to resort to direct data entry because even providers that get a timely software update will have to deal with bugs and obtain patches."

Having a backup plan to use DDE will help limit cash flow issues. "If providers are not ready with backup systems, we are very concerned about what's going to happen with cash flow for providers that have any Medicare volume," says Lang.

How to train new billets easily

"When we teach new facilities how to bill Medicare, we never allow them to do batch billing," says Lang. "When providers batch, the software submits the bills automatically. So if claims come back [marked] 'return to provider; the billers aren't aware of why the claims are coming back."

SNF billers will get reason and rejection codes on their screens, Lang explains, but these codes can be difficult to understand. "Also, the billers aren't going to learn what the errors are until they go back and check the claims, which may occur three to five days after submission," she adds.

With DDE, the minute you hit the send key, FISS immediately tells you whether there is an error and what it is, says Lang. "So from a training perspective, DDE is good because billers then become more familiar with and understand the kinds of errors that occur."

To learn more about the information that you can access through FISS, take the free online FISS tutorial at www.cms.hhs.gov/MLNEdWebGuide/15_FISSTutorial.asp.

SNFs should also check their fiscal intermediary's (FI) Web site to obtain FI-specific DDE--user guides, as well as request forms to sign up for DDE access. Access it at www.cmshhs.gov/MLNProducts/Downloads/CallCenterTollNumDirectory.zip.

--Caralyn Davis, [e-mail]