Automatic shipment of expendable supplies
Wil Haines
Description
Collection
Title:
Automatic shipment of expendable supplies
Creator:
Wil Haines
Date:
8/12/2013
Text:
Hello Colleagues and Guests,
I've seen listserve information regarding this question posted in recent
months.
Following is information that I picked up from Medicare. I assume it is
still current.
Medicare Claims Processing Manual
Chapter 20 -Durable Medical Equipment, Prosthetics,
Orthotics, and Supplies (DMEPOS)
200 -
Automatic Mailing/Delivery of DMEPOS
(Rev. 1, 10-01-03)
Suppliers/manufacturers may not automatically deliver DMEPOS to
beneficiaries unless
the beneficiary, physician, or designated representative has requested
additional
supplies/equipment. The reason is to assure that the beneficiary
actually needs the
DMEPOS. Contractor review should be done on a post-pay basis.
A beneficiary or their caregiver must specifically request refills of
repetitive services
and/or supplies before a supplier dispenses them. A supplier may not
initiate a refill of
an order. The supplier must not automatically dispense a quantity of
supplies on a
predetermined regular basis.
A request for refill is different than a request for a renewal of a
prescription. Generally,
the beneficiary or caregiver will rarely keep track of the end date of a
prescription.
Furthermore the physician is not likely to keep track of this. The
supplier is the one who
will need to have the order on file and will know when the prescription
will run out and a
new order is needed. It is reasonable to expect the supplier to contact
the physician and
ask for a renewal of the order. This is consistent with the DMERC
Supplier Manual,
which states: The description of the item (on an order) may be
completed by someone
other than the physician (most commonly the supplier). However, the
physician must
review the order and signand date it to indicate agreement.
Again the supplier must notautomatically mail or deliver the DMEPOS to
the beneficiary
until specifically requested.The DMERCs inform suppliers of these
procedures via their
bulletins and trainingsessions. These procedures will benefit suppliers
by helping to
maximize claimsprocessing accuracy, and to reduce the likelihood of a
postpayment
claim denial becausethe DMEPOS were not medically necessary.
DMERCs must publish this information on their Web sites and in their
bulletins on an
annual basis.
I've seen listserve information regarding this question posted in recent
months.
Following is information that I picked up from Medicare. I assume it is
still current.
Medicare Claims Processing Manual
Chapter 20 -Durable Medical Equipment, Prosthetics,
Orthotics, and Supplies (DMEPOS)
200 -
Automatic Mailing/Delivery of DMEPOS
(Rev. 1, 10-01-03)
Suppliers/manufacturers may not automatically deliver DMEPOS to
beneficiaries unless
the beneficiary, physician, or designated representative has requested
additional
supplies/equipment. The reason is to assure that the beneficiary
actually needs the
DMEPOS. Contractor review should be done on a post-pay basis.
A beneficiary or their caregiver must specifically request refills of
repetitive services
and/or supplies before a supplier dispenses them. A supplier may not
initiate a refill of
an order. The supplier must not automatically dispense a quantity of
supplies on a
predetermined regular basis.
A request for refill is different than a request for a renewal of a
prescription. Generally,
the beneficiary or caregiver will rarely keep track of the end date of a
prescription.
Furthermore the physician is not likely to keep track of this. The
supplier is the one who
will need to have the order on file and will know when the prescription
will run out and a
new order is needed. It is reasonable to expect the supplier to contact
the physician and
ask for a renewal of the order. This is consistent with the DMERC
Supplier Manual,
which states: The description of the item (on an order) may be
completed by someone
other than the physician (most commonly the supplier). However, the
physician must
review the order and signand date it to indicate agreement.
Again the supplier must notautomatically mail or deliver the DMEPOS to
the beneficiary
until specifically requested.The DMERCs inform suppliers of these
procedures via their
bulletins and trainingsessions. These procedures will benefit suppliers
by helping to
maximize claimsprocessing accuracy, and to reduce the likelihood of a
postpayment
claim denial becausethe DMEPOS were not medically necessary.
DMERCs must publish this information on their Web sites and in their
bulletins on an
annual basis.
Citation
Wil Haines, “Automatic shipment of expendable supplies,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/235460.
