Medicare Proof of Delivery Requirements

Applicability:

O&P’s, DME’s, Physician Offices

The Issue:

Standing alone, the physical delivery of a prosthetic or bracing (orthotic) device does not serve as valid proof that you delivered a Medicare beneficiary the item(s) you submitted for reimbursement. Medicare requires that you document delivery and prescribes exactly how to do so.

What You Need to Know:

Proof of delivery is one of the 30 Medicare Supplier Standards you are required to satisfy. The POD form should contain the following elements:

1. Beneficiary’s name;
2. Delivery address;
3. A description of the item(s) delivered (can be either a narrative description (e.g., prosthetic socket, knee and foot; lumbar-sacral orthosis), a CPCS code, the long description of a HCPCS code, or a brand name/model number);
4. Quantity;
5. Delivery date; and
6. Beneficiary or designee (if patient is a minor or not competent to sign) signature.

If you are shipping an off-the-shelf orthosis directly to a patient’s home, the POD should also include the delivery service’s tracking information for the item, supplier invoice number, or similar method that connects your delivery documents with the delivery service’s records.

You must retain proof of delivery for 7 years.

What This Means for You:

Make sure that every time you deliver a prosthetic or bracing (orthotic) device to your patients, you get signed proof of delivery. While it is a basic requirement with no exceptions, a surprisingly high percentage of retroactively-denied claims are the result of missing POD forms. If you do not have POD documentation, Medicare’s contractors will either deny your claim or recoup amounts already paid.