Current through Register Vol. 24-18, September 15, 2024
(1)
When a provider delivers an item directly to the client or the client's
authorized representative, the provider must furnish the proof of delivery when
the medicaid agency requests that information. All of the following apply:
(a) The agency requires a delivery slip as
proof of delivery. The proof of delivery slip must:
(i) Include the client's name and a detailed
description of the item(s) delivered, including the quantity and brand name;
and
(ii) For medical equipment
that may require future repairs, include the serial number.
(b) When the provider or supplier
submits a claim for payment to the agency, the date of service on the claim
must be one of the following:
(i) For a
one-time delivery, the date the item was received by the client or the client's
authorized representative; or
(ii)
For nondurable medical supplies for which the agency has established a monthly
maximum, on or after the date the item was received by the client or the
client's authorized representative.
(2) When a provider uses a delivery/shipping
service to deliver items which are not fitted to the client, the provider must
furnish proof of delivery that the client received the equipment and/or supply,
when the agency requests that information.
(a)
If the provider uses a delivery/shipping service, the tracking slip is the
proof of delivery. The tracking slip must include:
(i) The client's name or a reference to the
client's package or packages;
(ii)
The delivery service package identification number; and
(iii) The delivery address.
(b) If the provider/supplier does
the delivering, the delivery slip is the proof of delivery. The delivery slip
must include:
(i) The client's
name;
(ii) The shipping service
package identification number;
(iii) The quantity, detailed description(s),
and brand name or names of the items being shipped; and
(iv) For medical equipment that may require
future repairs, the serial number.
(c) When billing the agency, use:
(i) The shipping date as the date of service
on the claim if the provider uses a delivery/shipping service; or
(ii) The actual date of delivery as the date
of service on the claim if the provider/supplier does the delivery.
(3) A provider must not
use a delivery/shipping service to deliver items which must be fitted to the
client.
(4) Providers must obtain
prior authorization when required before delivering the item to the client. The
item must be delivered to the client before the provider bills the
agency.
(5) The agency does not pay
for medical equipment and related items furnished to the agency's clients when:
(a) The medical professional who provides
medical justification to the agency for the item provided to the client is an
employee of, has a contract with, or has any financial relationship with the
provider of the item; or
(b) The
medical professional who performs a client evaluation is an employee of, has a
contract with, or has any financial relationship with a provider of medical
equipment and related items.
11-14-075, recodified as §182-543-2200, filed 6/30/11,
effective 7/1/11. Statutory Authority:
RCW
74.08.090 and
74.04.050. 11-14-052, §
388-543-2200, filed 6/29/11, effective 8/1/11. Statutory Authority:
RCW
74.08.090,
74.09.530. 02-16-054, §
388-543-2200, filed 8/1/02, effective 9/1/02; 01-01-078, § 388-543-2200,
filed 12/13/00, effective 1/13/01.
