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Home Health & Hospice Week

Industry Note:

Decode Your Appeal Status In DDE With This Info

Published on Thu Sep 13, 2012

Once you've filed an appeal for a Medi-care claim, you can turn to the Direct Data Entry system for updates. "To help reduce the need to contact the [Provider Contact Center] regarding the status of an appeal, please note that Palmetto GBA providers are notified of an appeal decision via the Remittance Advice (RA) or providers may check the status of an appeal in the Direct Data Entry (DDE) system," the HHH MAC instructs on its website.Once a redetermination has been made, providers will find these explanatory abbreviations outlined in DDE on page four: CREV or PCREV (fully favorable, full reversal), PPREV (partially favorable, partial reversal), and AFFIRM or AFFM (unfavorable, denied).Take note: "Palmetto GBA does not issue letters for fully favorable appeals," the MAC re-minds providers.
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