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https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE19003.pdf
Medicare contractors will consider the proof of delivery requirements met for this type of beneficiary if the supplier has obtained a statement, signed and dated by the beneficiary (or beneficiary's designee), that the supplier has examined the item.
http://prsrxnetwork.com/instructions/cs_dmepos_setup_and_delivery.pdf
DMEPOS SETUP and PROOF OF DELIVERY COPYRIGHTTAG 1 FACILITYTAG, PHONETAG Patient Name: Date of Birth: Purchase Rental Picked Up at Facility Counter Delivered Patient/Caregiver Home Delivered Residential Care Setting Shipped to Patient Delivery/Shipping Address: Shipping Company Shipping Tracking/Invoice Number Date ShippedFile Size: 765KB
https://www.cgsmedicare.com/jc/pubs/news/2009/0109/cope9217.html
Jan 27, 2009 · Proof of delivery is required in order to verify that the beneficiary received the DMEPOS billed. Proof of delivery documentation must be maintained in the supplier's files for seven years. If the supplier delivers the DMEPOS directly to the beneficiary, a signed and dated delivery slip offers proof of delivery if it contains sufficient detail to identify the items and verify that they were correctly coded.
https://aappm.org/wp-content/uploads/2015/09/DME-Receipt-6-4-2014.pdf
A supplier is responsible for delivery and must instruct beneficiaries on use of Medicare-covered items, and maintain proof of delivery. 13. A supplier must answer questions and respond to complaints of beneficiaries, and maintain documentation of such contacts.File Size: 39KB
https://www.cgsmedicare.com/jc/pubs/news/2014/0814/cope26478.html
Aug 07, 2014 · Auto-filling the date of delivery on delivery documentation or Proof of Delivery (POD) is a common business practice for many DMEPOS suppliers. Upon delivery, the Medicare beneficiary or designee is required to review the POD and must provide his or her signature, which signifies knowledge, approval and acceptance of the delivery.
https://www.ngsmedicare.com/ngs/portal/ngsmedicare/!ut/p/a0/VY5PD4IgGIc_iwfOaF5cN_-0LmktDyY3sjelIRCCrW8faGtrY--e3zP4vWCCL5gIOrOeGiYF5S63r27cKmoGFMUpCqt9XcKNdVRDLoUBYapd86eXfLJX7pJvmVBYUmEpd1BbpTgDvQoU5gNVBjSKNlniRyE7O7rO5aFr0VLevV9nAZzNoN-ez_C0TIO_POEGE0wOxwy3K-QriH76yYW__mE1m9xn_RJn1DgmsT9pEHwA3Ox4cQ!!/
This type of proof of delivery record must contain the information specified above. Method 3—Delivery to Nursing Facility on Behalf of a Beneficiary. When a supplier delivers items to a nursing facility, the documentation described for Method 1 is required. When a delivery service is used to deliver the item to a nursing facility, the documentation described for Method 2 is required.
https://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/Electronic-Clinical-Templates/DMEPOS-Templates/DMEPOS-Templates
Templates and Suggested Clinical Data Elements (CDEs) for Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS) You can use the printable clinical templates or suggested CDEs to assist with documenting the following for certain DMEPOS items:
https://med.noridianmedicare.com/web/jddme/forms
CMS-1500 Claim Form This form is the prescribed form for claims prepared and submitted by physicians or suppliers. It can be purchased in any version required by calling the U.S. Government Printing Office at 202-512-1800.
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