Orthopedic Coding Alert

Question: What are the necessary requirements for physician signatures? Are E-signatures equally acceptable as handwritten signatures? Is it advisable to use signature logs?

Minnesota Subscriber

Answer: Your physician must include either a handwritten or electronic signature to authenticate the services provided for a patient.

What is a valid signature? According to Medicare, a valid signature must:

Authenticate services that the practitioner provided.

Be handwritten or electronic — unless the author has a physical disability that prevents him/her from providing a signature. In these cases, the provider can use a stamped signature if he/she “can provide proof to a CMS contractor of an inability to sign due to a disability.”

Be legible.

E-signature caution: According to CMS, an electronic signature is valid as well, with some stipulations. Your practice’s software/computer system must have protections against electronic signature modifications; these standards should be stringent enough to correspond with any current signature laws on the books.

CMS encourages providers to check with attorneys and malpractice insurers to be sure their electronic signatures meet all of the standards and regulations insurers have put forth.

Consider a signature log: In an effort to make the signature process more streamlined, Medicare does allow practices to keep a “signature log” on file for signing documents. A signature log is a typed list of all of your practice’s healthcare providers, which includes their names and a corresponding signature.

Do not ever miss a signature: If you submit claims without a signature, you could be heading towards denials. If payers detect a consistent pattern of signature-deficient claims, you could potentially face much worse penalties.