Direct Data Entry: Claims Submission Methods to Review

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Healthcare companies use the Direct Data Entry (DDE) method to manually enter, correct, and adjust entries. Medicare developed its information transfer mode, and it is still in use.

Direct Data Entry

DDE in Medicare Fiscal Intermediately shared system FISS is a common practice in most healthcare facilities. The DDE users use it to manually enter, correct, adjust or cancel Medicare transactions in FISS. The manual data entry may affect revenue cycle management. The critical issues of DDE are time and data reconciliation.

Presenting claims through DDE, the back-office staff must re-enter complete data into FISS. This duplication of work takes double the time for presenting a claim.

While working with DDE, the Host system may not update the changes in claims. Therefore, the update in host systems will cause discrepancies in claims.

Electronic Data Interchange

Electronic data interchange (EDI) is defined as the Computer-to-computer transfer of data. The data is transferred through the appropriate application from one computer to another.

Order Management System is an example of EDI. It does not involve any human handling. EDI can replace postal mail, fax, or email. Email is also an electronic method of data transfer handled by a human being. A typical manual process involves paperwork and people.

EDI transactions include an invoice for payment or transfer of funds, claims status, eligibility, Enrollment and disenrollment, referrals, coordination of benefits, premium, claims, and patient/provider encounter information.

With the introduction of AI in healthcare, the industry has been transformed at large.

Benefits of EDI over DDE

Time-Saving

EDI is a time-saving method through which your staff doesn’t need keen working — whereas your staff must be keen enough to make correct entries at a fast pace. EDI does not involve human handling, the chances of duplication, and discrepancies.

Usually, Medicare process the claims on certain days of the month, so the clean submitted claims are cleared, and the provider gains the Accounts Receivables. The fast processing of claims helps to maintain the revenue cycle management.

Usually, trying to keep a fast pace of data entry may lead to human errors. Your staff needs to re-enter complete data in FISS, which is time-consuming, but the ch...

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