DME Proof of Delivery: Requirements, Best Practices, and How to Stay Audit-Ready

Proof of delivery documentation is one of the top reasons DME claims get denied or recouped during audits. If you can't prove the equipment reached the patient, you don't get paid—even if the delivery actually happened.

For DME suppliers, proper proof of delivery (POD) isn't optional. It's a Medicare supplier standard under 42 CFR §424.57(c)(12), and most commercial payers have similar requirements. When auditors from the DME MAC, RAC, CERT, or UPIC come knocking, your POD documentation needs to be complete and accessible.

This guide covers exactly what's required, common mistakes that trigger denials, and how to build a POD process that keeps you audit-ready.

What is Proof of Delivery?

Proof of delivery is documentation that confirms durable medical equipment was actually delivered to and received by the patient (or their authorized representative). It serves as evidence that the billed items reached the intended recipient at a specific time and place.

POD documentation must be available upon request from Medicare contractors and is often required as a condition of payment. Without it, claims will be denied and any payments already received will be recouped.

Medicare POD Requirements

Medicare requires different levels of POD documentation depending on how the item was delivered. Here's what you need for each method:

Items Delivered Directly by the Supplier

When your driver delivers equipment to the patient, you need a delivery ticket that includes:

• Patient name - Must match the claim
• Delivery address - Where the item was actually delivered
• Delivery date - Must match or precede the date of service on the claim
• Detailed item description - Quantity, brand name, and serial number (if applicable)
• Signature of the patient or authorized representative
• Printed name of the person signing (if different from patient)
• Relationship to patient (if signed by representative)

Items Shipped via Carrier (UPS, FedEx, USPS)

For items shipped to the patient, you need:

• Shipping invoice with patient name, address, and shipping date
• Detailed description of items shipped (quantity, brand, serial numbers)
• Carrier tracking information showing delivery confirmation
• For items over $100: Signature confirmation from the carrier OR a return delivery postcard signed by the patient

Items Picked Up by the Patient

When patients pick up equipment at your location:

• Patient name and pickup date
• Detailed description of items
• Patient signature confirming receipt

Common POD Mistakes That Cause Denials

We've seen the same POD problems cause claim denials over and over. Here are the most common:

1. Missing or Illegible Signatures

Paper delivery tickets get wet, crumpled, or scribbled on. If the auditor can't read the signature or it's missing entirely, the claim gets denied. This is the single biggest POD-related denial reason.

2. Date Mismatches

The delivery date on your POD must match or precede the date of service on the claim. If you bill for January 15 but your delivery ticket shows January 18, that's an automatic denial.

3. Vague Item Descriptions

"Wheelchair" isn't enough. The POD needs to show the specific item delivered—brand, model, and serial number for serialized equipment. Auditors want to see that what was delivered matches what was billed.

4. Missing Representative Information

If someone other than the patient signs for delivery, you need their printed name and relationship to the patient. A signature alone from "the person who answered the door" won't hold up.

5. Lost Documentation

You're required to retain POD documentation for seven years from the date of service. Paper systems make this difficult—tickets get misfiled, damaged, or lost. When the audit request comes, you have days to respond, not weeks to search.

6. No Documentation for Shipping

Relying on carrier tracking alone isn't enough. You need to maintain your own records linking the shipment to the specific items and patient. If the carrier's records don't show what was in the box, you have a problem.

Best Practices for Audit-Ready POD

Building a solid POD process isn't complicated, but it requires consistency. Here's what works:

Capture Signatures Digitally

Electronic signature capture eliminates the biggest POD problems: illegible signatures, lost paperwork, and incomplete information. When the driver hands over equipment, the patient signs on a tablet or phone, and the record is instantly saved with a timestamp and GPS location.

Digital signatures are:

• Always legible
• Automatically dated and timestamped
• Linked directly to the order and patient record
• Stored securely and accessible instantly
• Impossible to lose or misfile

Build POD Requirements into Your Workflow

Don't rely on drivers to remember what information to collect. Your delivery system should prompt for required fields and not allow completion until everything is captured. Required fields should include:

• Patient/representative signature
• Printed name (if representative)
• Relationship to patient (if representative)
• Confirmation of items delivered

Link POD to Orders Automatically

When a delivery is completed, the POD documentation should automatically attach to the patient record and order. No manual filing, no searching later. When you need to respond to an audit, you can pull everything in seconds.

Verify Addresses Before Delivery

Address verification before dispatch prevents deliveries to wrong locations. If the delivery address doesn't match the patient's address on file, flag it for review before the driver leaves.

Train Your Drivers

Even with good systems, drivers need to understand why POD matters. They should know:

• Never leave equipment without a signature (unless specifically authorized for no-contact delivery)
• Verify the identity of the person signing
• Confirm item descriptions match what's being delivered
• What to do if the patient isn't home

Conduct Regular Internal Audits

Don't wait for Medicare to audit you. Review a sample of your POD documentation monthly to catch problems before they become patterns. Look for:

• Missing signatures or information
• Date discrepancies
• Incomplete item descriptions
• Orders missing POD entirely

What Happens During a POD Audit

When you receive an Additional Documentation Request (ADR) from a Medicare contractor, you typically have 30-45 days to respond. The request will specify which claims need documentation.

For each claim, you'll need to provide:

• Proof of delivery documentation
• Physician order/prescription
• Medical necessity documentation
• Any prior authorization records

If your POD is incomplete or can't be located, the claim will be denied. If it's a post-payment audit, you'll need to refund the payment.

Suppliers with patterns of POD problems may face:

• Prepayment review (all claims held until documentation is reviewed)
• Increased audit frequency
• Potential fraud investigations for repeated issues

Paper vs. Digital: The Real Cost

Many DME suppliers still use paper delivery tickets. Here's how paper and digital compare:

Paper-based POD:

• Tickets can be lost, damaged, or illegible
• Manual filing required after every delivery
• Searching for documentation takes hours
• No backup if originals are lost
• Difficult to verify completeness

Digital POD:

• Signatures captured clearly every time
• Automatic filing linked to patient/order
• Instant search and retrieval
• Automatic backup and redundancy
• System enforces required fields

The cost of one denied claim or recoupment often exceeds a year's worth of software. And the time your staff spends managing paper—filing, searching, responding to audits—adds up fast.

Stay Audit-Ready

Proof of delivery isn't just paperwork—it's protection. Every delivery your team makes should generate documentation that can withstand an audit years later.

The key is building POD capture into your delivery workflow so it happens automatically, every time, with no gaps. When auditors request documentation, you should be able to pull complete records in minutes, not days.

That's exactly the kind of system we built with DME Engine. Digital signature capture, automatic documentation linking, and instant retrieval—all designed by people who've been through DME audits and know what it takes to pass them.