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Having trouble reading this email? View it in your browser. Request for Refill - Documentation For all DMEPOS items that are provided on a recurring basis, suppliers are required to have contact with the beneficiary prior to dispensing a new supply of items. (Contact with a caregiver/ designee also meets the requirements that are specified in this article.) For items that the patient obtains at a retail store site, the signed delivery slip is sufficient documentation of a request for refill. For items that are delivered to the beneficiary s home or nursing home by the supplier or third party delivery service, documentation of a request for refill must be either a written document received from the beneficiary or a contemporaneous written record of a phone conversation/contact between the supplier and beneficiary. A retrospective attestation statement by the supplier or beneficiary is not sufficient. If it is a written document received from the beneficiary, the documentation should contain the following or equivalent information: Beneficiary s nameA description of each item or of each type of item that is being requested (e.g., diabetic testing supplies, inhalation drugs, nebulizer accessories, etc.); a list of each separate item is not requiredA statement that the beneficiary is requesting a refill of the itemsBeneficiary signature (If signed by a caregiver, indicate relationship to beneficiary)Date of signatureIf it is a record of a phone conversation, the documentation should contain the following or equivalent information: Beneficiary s namePerson contacted (i.e., beneficiary or caregiver [list name])A description of each item or of each type of item that is being requested; a list of each separate item is not requiredA statement that the beneficiary is requesting a refill of the itemsDate of contactIf the phone contact involves use of an automated response system, the record of that contact should contain similar information. Other useful information that might be obtained at the time of contact with the beneficiary includes but is not limited to: Quantity of supplies that the beneficiary still hasHow often the beneficiary has been testing/taking a drug/using or replacing an itemWhether the beneficiaries is also receiving the items from another supplier Additional information on requests for refill: Medicare Coverage Database, article, March 2009 - Beneficiary Request for Refill of Supplies, Accessories, and DrugsJurisdiction B Connections, June 2009 - Beneficiary Request for Refill of Supplies, Accessories, and DrugsMedicare Program Integrity Manual, Pub 100-08, Chapter 4, Section 4.26.1Medicare Claims Processing Manual, Pub 100-04, Chapter 20, Section 200 Remember! National Government Services' Jurisdiction B DME MAC List serv is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank You! National Government Services encourages all Web site users to provide feedback regarding ways to improve our Web site. The ForeSee Results (pop-up) survey is an easy mechanism for providers to use to let us know how we can best serve you. Your comments play a large role in the enhancements that are made to the National Government Services Web site. CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message. National Government Services Inc. 8115 Knue Road | Indianapolis, IN 46250 This email was sent to: This e-mail address is being protected from spambots. You need JavaScript enabled to view it Unsubscribe Powered by MailerMailer |