Medicare Compliance & Reimbursement

Trouble lurks when two out of three reviewers can't read handwriting.

Illegible handwriting isn't just a charming quirk - carriers can deny claims if they decide a doctor's supporting documentation is unreadable. And if a pharmacist misreads a prescription and dispenses the wrong drug, a doctor could face malpractice suits and licensure issues.

The Institute for Safe Medicine Practices issued a white paper in 2000 on the danger of handwritten prescriptions, which details the costs of unreadable scrawls. In October 1999, a court ordered a Texas cardiologist to pay $225,000 to the family of a patient who received Plendil instead of Isordil because the pharmacy misread the physician's unreadable prescription. 

Carrier claims reviewers have a rule of thumb that if two out of three reviewers can't read a document, it's officially unreadable, according to Quinten Buechner with ProActive Consultants in Cumberland, WI.

If a doctor insists a document is legible, he can try transcribing it, but the transcription must have the same number of words "as the mess [the doctor] looked at in the first place."

Some states may even punish doctors who write illegibly. "The state of Wisconsin has a law that puts the license in jeopardy if the notes are illegible," notes Buechner. Also, Florida state law requires legible prescriptions.