1. NPM Knowledge Base
  2. Medical billing in dentistry

Proof of Delivery

Documenting proof of deliver for DME suppliers for sleep appliances for reimbursement from Medicare

A POD (proof of delivery) is part of the Documentation Requirements for Medicare DME Suppliers. Put simply – a POD is proof that a patient received a piece of DME (Durable Medical Equipment). A POD is a required piece of documentation for dental offices signed up as Medicare DME suppliers who are supplying custom made oral appliances for OSA (Obstructive Sleep Apnea) which is billed under HCPCS code E0486.

You will find a sample POD in your DentalWriter software. Located in any patient’s chart under the “QuickLetters” tab. Use the “search by keyword” button, type in the work “proof”, then click the “Search Now” button. Select the sample POD form, then click “Create letter now” button. The sample POD will open in Microsoft word.

Below is a copy of the additional information provided in the Medicare DME Supplier manual about POD’s:

Proof of delivery (POD) is a Supplier Standard and DMEPOS suppliers are required to maintain POD documentation in their files. For medical review purposes, POD serves to assist in determining correct coding and billing information for claims submitted for Medicare reimbursement. Regardless of the method of delivery, the contractor must be able to determine from delivery documentation that the supplier properly coded the item(s), that the item(s) delivered are the same item(s) submitted for Medicare reimbursement and that the item(s) are intended for, and received by, a specific Medicare beneficiary.
Suppliers, their employees, or anyone else having a financial interest in the delivery of the item are prohibited from signing and accepting an item on behalf of a beneficiary (i.e., acting as a designee on behalf of the beneficiary). The signature and date the beneficiary or designee accepted delivery must be legible.

For the purpose of the delivery methods noted below, designee is defined as “Any person who can sign and accept the delivery of durable medical equipment on behalf of the beneficiary.”
Proof of delivery documentation must be available to the Medicare contractor on request. All services that do not have appropriate proof of delivery from the supplier will be denied and overpayments will be requested. Suppliers who consistently fail to provide documentation to support their services may be referred to the OIG for imposition of Civil Monetary Penalties or other administrative sanctions.

Suppliers are required to maintain POD documentation in their files. There are three methods of delivery:
1.Delivery directly to the beneficiary or authorized representative
2.Delivery via shipping or delivery service
3.Delivery of items to a nursing facility on behalf of the beneficiary

Method 1—Direct Delivery to the Beneficiary by the Supplier
Suppliers may deliver directly to the beneficiary or the designee. In this case, POD to a beneficiary must be a signed and dated delivery slip. The POD record must include:
•Beneficiary’s name
•Delivery address
•Sufficiently detailed description to identify the item(s) being delivered (e.g., brand name, serial number, narrative description)
•Quantity delivered
•Date delivered

•Beneficiary (or designee) signature and date of signature
The date of signature on the delivery slip must be the date that the DMEPOS item was received by the beneficiary or designee. In instances where the supplies are delivered directly by the supplier, the date the beneficiary received the DMEPOS supply must be the date of service on the claim.

Method 2— Delivery via Shipping or Delivery Service Directly to a Beneficiary

If the supplier utilizes a shipping service or mail order, the POD documentation must be a complete record tracking the item(s) from the DMEPOS supplier to the beneficiary. An example of acceptable proof of delivery would include both the supplier’s own detailed shipping invoice and the delivery service’s tracking information. The supplier’s record must be linked to the delivery service record by some clear method like the delivery service’s package identification number or supplier’s invoice number for the package sent to the beneficiary. The POD record must include:
•Beneficiary’s name
•Delivery address
•Delivery service’s package identification number, supplier invoice number or alternative method that links the supplier’s delivery documents with the delivery service’s records.
•Sufficiently detailed description to identify the item(s) being delivered (e.g., brand name, serial number, narrative description)
•Quantity delivered

•Date delivered
•Evidence of delivery

If a supplier utilizes a shipping service or mail order, suppliers must use the shipping date as the date of service on the claim.
Suppliers may also utilize a return postage-paid delivery invoice from the beneficiary or designee as a POD. This type of POD record must contain the information specified above.

Method 3—Delivery to Nursing Facility on Behalf of a Beneficiary

When a supplier delivers items directly to a nursing facility, the documentation described for Method 1 (see above) is required.
When a delivery service or mail order is used to deliver the item to a nursing facility, the documentation described for Method 2 (see above) is required.
Regardless the method of delivery, for those beneficiaries that are residents of a nursing facility, information from the nursing facility showing that the item(s) delivered for the beneficiary’s use were actually provided to and used by the beneficiary must be available upon request.

Exceptions


Exceptions to the preceding statements concerning the date(s) of service on the claim occur when the items are provided in anticipation of discharge from a hospital or nursing facility. A supplier may deliver a DMEPOS item to a patient in a hospital or nursing facility for the purpose of fitting or training the patient in the proper use of the item. This may be done up to two days prior to the patient’s anticipated discharge to their home. The supplier shall bill the date of service on the claim as the date of discharge and use the place of service (POS) as 12 (patient’s home). The item must be for subsequent use in the patient’s home. No billing may be made for the item on those days the patient was receiving training or fitting in the hospital or nursing facility.
A supplier may not bill for drugs or other DMEPOS items used by the patient prior to the patient’s discharge from the hospital or a Medicare Part A nursing facility stay. Billing the DME MAC for surgical dressings, urological supplies, or ostomy supplies that are provided in the hospital or during a Medicare Part A nursing facility stay is not allowed. These items are payable to the facility under Part A of Medicare. This prohibition applies even if the item is worn home by the patient from the hospital or nursing facility. Any attempt by the supplier and/or facility to substitute an item that is payable to the supplier for an item that, under statute, should be provided by the facility, may be considered to be fraudulent. These statements apply to DME delivered to a patient in hospitals, skilled nursing facilities (POS = 31), or nursing facilities providing skilled services (POS = 32).