A while back, CMS issued a reminder MLN Article to recap the current proof of delivery provisions. Proof of delivery is a significant element of many patient encounters, and a quick review is useful for new and experienced employees.
CMS accepts three delivery methods:
Date of Service Depends on the Delivery Method
For billing purposes, the date of service should generally be the date the beneficiary received the product unless a shipping service is used.
For a shipped product, the date of service is either the label creation date or the date the delivery service collects the package. While either date is valid for CMS, MiraVista recommends suppliers consistently select one or the other.
[Competitive Bid 2021, Medicare revalidation activity, and more ... stay in the know with (K)notes. Attend the live webinar with attendee Q&A on Wednesday, April 24, 2019, at 1:00 PM (ET).]
In-Patient Deliveries
The MLN Article does not mention delivery to beneficiaries in hospitals, but the in-patient exception remains valid. For these deliveries, the date of service can be changed to the date of discharge if three criteria are met:
If the beneficiary is discharged more than 48 hours after delivery, suppliers must recreate the delivery paperwork.
Newly Eligible Beneficiaries
For newly eligible beneficiaries who already have DME and switch from another insurance to Medicare, the supplier must first ensure all Medicare requirements for payment are met (consult the LCD for the product in question).
Unless there is a change in medical need, most suppliers do not swap equipment for a simple change in insurance. For proof of delivery purposes, however, suppliers must secure a signed and dated statement from the beneficiary, or their designee, to certify that the supplier has examined the equipment and determined it to be in working order. The supplier is then liable to keep the equipment operational for the full useful lifetime.
Medicare establishes a new useful lifetime on the first day of the first paid rental month. Suppliers are obligated to keep the equipment in functioning order for the full lifetime under Medicare.
Failure to produce satisfactory proof of delivery documentation in the course of an audit will result in denials, so make sure your staff is familiar with the latest guidelines.
SOURCE LINKS
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE19003.pdf
CMS accepts three delivery methods:
- Direct delivery.
- Delivery via a shipping service.
- Delivery to a skilled nursing facility.
Date of Service Depends on the Delivery Method
For billing purposes, the date of service should generally be the date the beneficiary received the product unless a shipping service is used.
For a shipped product, the date of service is either the label creation date or the date the delivery service collects the package. While either date is valid for CMS, MiraVista recommends suppliers consistently select one or the other.
[Competitive Bid 2021, Medicare revalidation activity, and more ... stay in the know with (K)notes. Attend the live webinar with attendee Q&A on Wednesday, April 24, 2019, at 1:00 PM (ET).]
In-Patient Deliveries
The MLN Article does not mention delivery to beneficiaries in hospitals, but the in-patient exception remains valid. For these deliveries, the date of service can be changed to the date of discharge if three criteria are met:
- The equipment or service must be designated for in-home use and cannot be used during the hospital stay.
- The delivery to the in-patient facility must be for fitting or training purposes.
- The beneficiary must be discharged within 48 hours of the original delivery.
If the beneficiary is discharged more than 48 hours after delivery, suppliers must recreate the delivery paperwork.
Newly Eligible Beneficiaries
For newly eligible beneficiaries who already have DME and switch from another insurance to Medicare, the supplier must first ensure all Medicare requirements for payment are met (consult the LCD for the product in question).
Unless there is a change in medical need, most suppliers do not swap equipment for a simple change in insurance. For proof of delivery purposes, however, suppliers must secure a signed and dated statement from the beneficiary, or their designee, to certify that the supplier has examined the equipment and determined it to be in working order. The supplier is then liable to keep the equipment operational for the full useful lifetime.
Medicare establishes a new useful lifetime on the first day of the first paid rental month. Suppliers are obligated to keep the equipment in functioning order for the full lifetime under Medicare.
Failure to produce satisfactory proof of delivery documentation in the course of an audit will result in denials, so make sure your staff is familiar with the latest guidelines.
SOURCE LINKS
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE19003.pdf
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