RETIRED - ACA Requirement for Indicating Receipt Date of Documentation - JA DME
RETIRED - ACA Requirement for Indicating Receipt Date of Documentation
This article has been retired on August 17, 2017. Please review the Standard Documentation Requirements for All Claims Submitted to DME MACs (A55426) for current information.
With the implementation of Affordable Care Act (ACA) Section 6407, there are local coverage determinations (LCDs) and related policy articles (PAs) that require suppliers to receive clinical documentation and orders within a specific period of time. According to these LCDs, "A date stamp or equivalent must be used to document receipt date." Documentation of the receipt date is a key requirement of these policies to demonstrate compliance with the statutory timeliness requirement.
Questions have arisen from suppliers about what methods are acceptable for documenting a receipt date. The DME MACs do not specify what method may be used to indicate date of receipt; however, there must be some indicator or notation on the documents that they were received by the supplier within the required time period. Some commonly accepted methods are hard-copy date stamps, hand-written dates, facsimile headers and electronic receipt dates. Regardless of the method used, it must be clear to contractor staff reviewing the claim that the date received meets the requirements in the applicable LCD.
A cautionary note about utilizing facsimile headers to document receipt date. Suppliers often rely on a fax header that includes a date and time indicator as an alternative to a date stamp. However, there are often multiple facsimile header lines that are the result of documents being faxed back and forth between the supplier and treating physician. Consequently, it is often difficult to determine the actual date of receipt of the documents by the supplier.
Suppliers should review their process for documenting the date of receipt of the documentation related to policies that requirement a receipt date. Suppliers must ensure that all documents clearly indicate the date that the documents were received. Suppliers who rely on fax header information should be especially vigilant to make sure that the receipt date is clearly indicated to avoid claim denials.
Last Updated Thu, 10 Jan 2019 13:01:17 +0000