17.4 Documentation of ReceiptWhen the equipment is delivered, providers must complete the CSHCN Services Program Documentation of Receipt form on page B-104 or the CSHCN Services Program Documentation of Receipt (Spanish) form on page B-105. The DME Documentation of Receipt form is required and must be completed before reimbursement can be made for any DME delivered to a client. The certification form must include the name of the item, the date the client received the DME, and the signatures of the provider and the client or primary caregiver. Providers must retain individual delivery slips or invoices for each DOS that document the date of delivery for all supplies provided to a client and must disclose them to HHSC or its designee upon request. Documentation of delivery must include one of the following:
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• Providers must maintain a copy of this form in their files for the life of the piece of equipment or until the equipment is authorized for replacement. The CSHCN Services Program does not reimburse providers separately for shipping and handling or freight charges, except when power equipment must be sent to a location other than to the vendor for repair. |
Delivery slip or invoice signed and dated by client or caregiver. The delivery slip or invoice must contain the client's full name and address to which the supplies were delivered, the item description, and the numerical quantities that were delivered to the client.
