Shipping routine supplies by mail is convenient for DME suppliers and customers.
But occasionally a customer claims they didn’t receive their supplies … even though the supplier has a delivery confirmation from the post office or delivery service.
Will Medicare reimburse the supplier for a replacement order?
They will! Packages that go missing after confirmed delivery by third-parties are often stolen, and Medicare will pay for replacement items when the originals are lost, stolen, or irreparably damaged.
Getting Paid to Replace Stolen Items
Medicare requires documentation confirming the theft. The best support is an official police report, but a formal written statement from the customer alleging theft and detailing relevant facts may suffice.
Once the supplier has documentation of the theft, they can provide identical – or nearly identical – items to the Medicare customer. To obtain reimbursement for the replacement items, suppliers should:
- Append the RA modifier to the claim for replacement items, and
- Include the narrative “Replacement due to theft.”
Repeated Thefts
The Medicare replacement policy is simple, but contractors will question repeated thefts, especially within a relatively short period of time … say 18-24 months. To avoid customer abuse and Medicare’s suspicion, suppliers should have a policy for dealing with customers claiming frequent losses. A good policy starts with educating customers on the importance of retrieving parcels promptly, and to the extent possible, creating a secure delivery drop for mailed packages. If shipments continue to go missing, suppliers should consider discontinuing delivery to the risky location.
We hope thieves don’t take advantage of Medicare beneficiaries, but when they do, we hope this will help suppliers ensure continued patient access without unfair financial consequences.
Frequently Asked Questions
Will Medicare reimburse a replacement for lost or stolen DME supplies?
Medicare may pay for replacement items when the originals are lost, stolen, or irreparably damaged, including a package that disappears after a third-party carrier confirms delivery. The supplier still needs documentation supporting what happened and must follow the replacement-claim requirements before providing identical or nearly identical items to the beneficiary.
What documentation should support a Medicare claim for stolen DME?
An official police report is the strongest documentation of theft. The article also notes that a formal written statement from the customer may be sufficient when it alleges the theft and explains the relevant facts. The supplier should keep that evidence with the claim record in case the Medicare contractor asks why a replacement was necessary.
How should a supplier bill Medicare for replacement items after theft?
The supplier should append the RA modifier to the replacement claim and include the narrative “Replacement due to theft.” Contractors may question repeated thefts within a relatively short period, so providers should educate customers about prompt parcel retrieval, encourage secure drop locations, and establish a policy for addresses with frequent missing shipments.
Related Articles