Direct Data Entry (DDE) access is a company’s revenue lifeline: without it, hospices cannot comply with NOE filing requirements or submit claims for payment.  Every hospice has DDE login rights, but many fail to recognize (and take due care to avoid) the serious hidden pitfalls that are found in this system.  Failure to avoid these pitfalls can cause loss of access; and, in turn, hospices face at least significant administrative work to recover access and perhaps forfeiture of certain billings (if NOEs cannot be timely filed).  Many hospices (and other Medicare providers) have found themselves in crisis mode based upon billing employee departures, forgotten passwords, and suspended/deactivated accounts.

Substantial care must be given to maintaining your provider’s DDE credentials.

Here are a few important DDE requirements to remember:

Annual Medicare DDE PPTN Recertification (DUE 9/30/19): Users must recertify their DDE credentials by completing an annual MAC recertification no later then September 30 of each year.  The 2019 deadline is coming up fast.  If a user does not recertify by September 30, on October 1 the user will lose access. Here are the links to reach your MAC recertification form:

• CGS: https://www.cgsmedicare.com/forms/annual_dde_pptn_recert_formRE.pdf
• NGS: https://enrolledi.ngsmedicare.com/ddelogon
• Palmetto: Users were emailed a specific form that needs to be faxed to 803-699-2429. If you cannot locate, or did not receive, the email, call 855-696-0705.

30 Day Access Requirement: In addition to annual recertification, users must also login to DDE system at least once every 30 days.  Failure to login at least this often will result in suspension or deactivation of your account.  Medicare does not send reminders; so, providers should set up recurring calendar items and use compliance tools to ensure that logins remain active.

Passwords: Users only have three attempts to enter a password correctly.  If a user fails three times, the user’s DDE credentials will be deactivated.  After two failures, users should close out of the DDE system and wait at least 30 minutes before trying again. If all else fails, users can call their MAC for a password reset.

And, every 30 days, Medicare requires each user to change passwords – to create a new eight letter, digit, and special character password. To make things even more difficult, Medicare has protocols to reject similar passwords.

Personal to Each User:  Medicare regards each DDE account as personal to an individual, meaning that they should not be shared.  This can create significant challenges when key billing employees leave a provider, or even when they are ill or go on vacation.

Changes to the Common Working File (CWF): By the end of 2019, Medicare will remove ELGA, ELGH, HIQA, and HIQH. Medicare floated this plan in 2012, but the change was stalled (due to HETS lacking all information needed for Hospice and Home Health Providers). On July 1, 2019, Medicare updated the CWF. When users enter ELGA, ELGH, HIQA, and HIQH they will now get a warning screen about the removal.  Once Medicare makes this change users will no longer be able to run eligibility. Users will need to obtain access to HETS through a third-party software or your MAC.

Best Practices.  Here are some recommended best DDE practices:

• Providers should maintain at least three active DDE accounts.

• Providers should set up institutional reminders to ensure monthly DDE logins.

• Providers should carefully maintain login and password credentials.

• Providers should even consider a back up plan, such as having your outside consultants maintain active DDE logins tied to your accounts for use in case of need.

About guest author Chris Pfund:  Chris co-founded hospices in Arizona, Colorado, and Idaho.  He presently runs Pfundamental Consulting (www.pfundamental.com; 602 726 2800), where he provides hospice billing, human resources, business operations, and management services.