Here’s the original post:
For those of you that see hospital in-patients (medicare, insurance, no
insurance), how do you handle delivery forms? A lot of patients are unable to
sign for a variety of reasons (medically induced coma, TBA, external fixators,
etc…). What do you do when there is not a family member available to sign?
Since hospital staff are not suppose to sign for Medicare patients, this can
become difficult.
ABC’s direct response regarding Medicare patients is that no one with monetary
interest in the beneficiary’s receipt of items can sign on behalf of the
beneficiary. Hospital staff may be getting into gray area.
So here are the responses…
1. I’ve never heard that hospital staff can’t sign. We have a spot on our
receipts for ‘acknowledgment of receipt only’ for staff/non family members to
sign. It seems appropriate if we’re billing the hospital for the device. But I
would be interested in hearing other responses.
2. On the Patient Signature line, write “unable to sign due to ___________”,
then initial it. Verification can be obtained from medical records if
necessary.
3. I write that the patient is ‘unable to sign’ and the nurse and I both
initial. We also have hospital staff sign for the delivery on the same form so
there is confirmation for the hospital as well. Then I usually write the reason
they could not sign in the chart notes.
4. We get a copy of the practitioner’s notes from the patient’s chart starting
they fit/delivered the item for our records as proof of delivery.
5. I just document in my chart notes why the pt. was unable to sign and state a
detailed reason. I believe most hospitals have pt. or family sign releases to
be treated by outside vendors that the hospital deems necessary so there should
be some coverage with that. Interested to hear your other responses though.
6. but hospital staff can witness that item was delivered to the patient room
along with printed instructions etc? All you need is according line on your
POD, if you have those situations routinely, like we had back when neuros wanted
us to have custom spinals waiting for the Pt BEFORE patient wakes up in the
recovery room, and we had no choice but to leave them there, along with detailed
printed instructions…
7. Work with the Unit Secretary or Nurse to contact you when the family members
arrive, then deliver during those times. That would be my suggestion. I would
also create a form letter to give to hospital floors where you frequent, and let
them know in advance of ways to help educate patients on the delivery process.
You could even ask them to advise the family members that one of them will have
to be present during delivery, before they call you for consultation and
treatment.
8. Actually, you have it backwards. ANY product delivered to a Medicare
patient in the hospital requires billing straight to the hospital. The hospital
staff are the ONLY ones who can sign for it.
In terms of a non-Medicare patient, most insurance companies will accept a
signature from the hospital staff. It there is any question about this, call
the insurance company in advance, and see what they would like you to do.
Despite the frustrations that we encounter with insurance companies, they really
are there to serve their patients.
Several people responded that they interested in the responses.
Thanks,
Elizabeth Hammer BOCO
B & H Orthopedic Lab
