Proof of Delivery Requirements

DMEPOS items delivered directly to the recipient by the supplier (method 1) typically require the signature of a payee (or agent) on the delivery document. During PSA, suppliers must document the delivery date and indicate that no signatures could be obtained due to COVID-19. In order for Medicare to make the payment, the beneficiary must meet all Medicare coverage, coding and documentation requirements for DMEPOS items that apply to the DOS of the original Medicare application. Contractors may withhold payment for items that do not have proof of delivery (or a certificate that equipment is working properly for a new eligible recipient). In certain circumstances, the provider may also be subject to investigation and sanction, including exclusion from the Medicare program. 42 CFR 424.57(c)(12) requires suppliers to keep POD documentation on file. An “agent” is any person who can sign and accept the delivery of EMRs on behalf of a beneficiary. Suppliers, their employees and any other person with a financial interest in the delivery of the item are prohibited from signing and accepting an item. A provider may provide a device, prosthesis or orthosis to a patient in a hospital setting rather than to the patient at home if they customize or train the patient in the appropriate use of the item. This delivery can be made up to two days before the patient`s scheduled discharge. What should be our point of action based on this information? In any case, we want to have proof of delivery documentation for every Medicare order we issue. But let`s not stop there.

We should extrapolate to one in three. Have proof of delivery signed for each order placed with patients for third parties. This is a simple but essential step. This way, you can answer the listener`s question if they want to see proof of delivery that you actually delivered the glasses/contact lenses they paid for to the patients. Generally, Medicare is the delivery date. There are three delivery methods. Regardless of the type of delivery, the contractor must be able to determine that the items delivered are the same as those subject to Medicare reimbursement and that the items were received by a specific beneficiary: Individuals newly eligible for the Medicare Fee for Service (FFS) program may have EMR items at home at the time of Medicare eligibility. Medicare does not automatically pay for an EMR item that was covered before a beneficiary was eligible for FFS.

If someone who receives an EMR from another payer is eligible for FFS, the beneficiary can only continue to receive those items if Medicare requirements are met. The date must also appear on the proof of delivery. The date has some possibilities. The date the recipient received the DMEPOS item must be the delivery date of the claim, or if you are using a delivery/shipping service, you can use the shipping date as the service date. Medicare published an article on January 17, 2019, summarizing proof of delivery requirements. The article is intended for “. Doctors, vendors, and suppliers who bill for durable medical devices. for items and services provided to Medicare beneficiaries. That`s us. We charge for reimbursable glasses/contact lenses for Medicare and deliver them to patients.

Therefore, separate delivery and service charges for DMEPOS items are not permitted, except in rare and unusual cases where delivery is outside the normal course of a supplier`s business. Suppliers can deliver directly to the recipient or agent. In this case, the POD to a beneficiary must be a signed and dated delivery document. The POD document must contain the following: For items that are delivered directly from the provider to a care facility, or if a delivery service or mail order is used to deliver the items to a care facility, the provider must have: What happens if you don`t? Medicare may withhold payment for items for which there is no proof of delivery. And if you`ve already been paid, Medicare will recover any overpayments due to such denied claims. Suppliers can also use a prepaid return invoice from the recipient or agent as a POD. This type of POD document must contain the above information. The delivery date on the POD must be the date the DMEPOS item is received by the beneficiary or agent. The delivery date can be entered by the payee, agent or supplier. If the supplier`s delivery documents contain both a date entered by the supplier and the date a beneficiary or beneficiary or beneficiary signed on the POD document, the date entered by the payee (or agent) is the proof of delivery (DOS). If the supplier uses a shipping or mail order service, the POD documentation must be a complete record that tracks items from the DMEPOS supplier to the payee.

An example of an acceptable POD would be both the supplier`s itemized shipping invoice and the delivery service`s tracking information. The vendor file must be linked to the delivery service record by a unique method such as the delivery service package identification number or the vendor invoice number for the package sent to the payee. The POD document must contain the following: For example, reasonable delivery charges may be allowed if a supplier needs to deliver a DMEPOS item to a recipient who resides outside the supplier`s usual customer area and has not had access to a nearby supplier. The supplier must fully document these “unusual circumstances” when claiming shipping charges. Proof of delivery requirements and documentation required to support compliance for payment purposes can be found in the Medicare Program Integrity Handbook, Chapter 4, Section 26. Once the glasses/contacts have been delivered, the beneficiary or agent must accept the item and sign it legibly. If the signature is not legible, the supplier/shipper must include the name of the beneficiary or agent on the packing slip. An important point is that the signatory is often not a party with a financial interest. You and your staff cannot sign that the patient received the item because you have a financial interest.

Suppliers, their employees or other persons who have a financial interest in providing the items are prohibited from signing and accepting an item on behalf of a recipient (i.e. acting as an agent on behalf of the recipient). The relationship between the agent and the beneficiary must be noted on the delivery note received by the supplier (i.e. spouse, neighbour). The representative`s signature must be legible. If the representative`s signature is not legible, the supplier/shipping service provider must note the agent`s name on the packing slip. There is another rule you need to know. You must keep the proof of delivery for seven years.

The delegate must sign and accept the article legibly. If the signature is not legible, the supplier or delivery service must note the name on the delivery note. The payee, agent or supplier must also indicate the delivery date. The date the recipient received the EMR position must be the date of delivery of the application. If a supplier uses a delivery service, the shipping date can be the delivery date on the claim. The shipping date can be set as the date the delivery service label was created or the date the item is picked up for delivery. There shouldn`t be much difference between the two. Suppliers must keep proof of delivery on file for seven years from the date of service. If the supplier who receives a request for proof of delivery responds in writing that the Medicare eligible supplier`s documentation is more than seven years old and provides proof of the continued medical necessity of the item or the need for repair, contractors cannot deny the claim solely because of the lack of supporting documentation for Medicare eligibility that is more than seven years old.