DJO/Enovis’ Revenue Cycle Management (RCM) team, along with the Corporate Compliance team, noticed a pattern with some payors – including Medicare – that we believe results from differences in the patient signature date and the product dispense/delivery date when both dates are included on the same Patient Agreement (PA) form. While there are situations in which a patient signature date and a dispense/delivery date are not the same, these payors have used this situation as a reason for denying DJO/Enovis’ claims for payment. After researching the topic, the RCM team learned that, when a PA or other similar form contains BOTH a patient signature date AND a product dispense/delivery date, the patient signature date serves as the Date of Service (DOS) for billing purposes (see the Centers for Medicare and Medicaid Services (CMS) Local Coverage Article AA5426 titled “Standard Documentation Requirements for All Claims Submitted to DME MACs”). To reduce payor confusion concerning conflicting dates, DJO/Enovis decided to remove the patient signature date, which is NOT a required element for all claims submitted to Medicare or to other payors and, instead, include ONLY the product dispense/delivery date. The product dispense/delivery date may be entered on a PA by the Medicare beneficiary, by the beneficiary’s designee, or by the DMEPOS supplier.
See the attached PDF for updates made to the MotionMD Patient Agreement to comply.