Practice Management Alert

Answer #1: From a risk management perspective, you should have the original top copy from a duplicate carbon form "because then you can show an original signature," says Robert A. Pelaia, JD, CPC, director of compliance at the University of Florida in Jacksonville. However, there may not be a specific rule you can pinpoint to prove this to your doctor. During an audit, not having this type of original documentation may or may not be a problem, depending on the circumstances, he says.

But regardless of legal documentation requirements, keeping the original form for your records "just makes more sense," Pelaia says. If it's a simple question of which copy to give the patient, the doctor should keep the original and give the patient the carbon copy. The same principle applies to photocopied documents: If your patient asks for a copy, keep the original and hand over the photocopy.

Answer #2: Signature stamps are very risky. "Doctors should do some serious research into the validity of a signature stamp" before deciding to use one, Pelaia says. "I always advise against them ... they can get you into trouble."

Many carriers have a provision dictating the use of signature stamps. For example, the Florida Medicaid program states a physician can use a signature stamp but has to initial it. The danger, therefore, is that the doctor can forget to initial after he stamps, Pelaia says.

And signature stamps easily lend themselves to misuse and abuse. Many physicians will ask their secretary or assistant to stamp all their notes, but this can be incriminating in the event of an audit or other investigation, Pelaia says. If a doctor has someone else stamping his notes, there is no evidence he directly reviews his reports and stays current on his patients'status -- and that can create a huge legal problem. To play it safe, tell physicians to avoid signature stamps completely, he advises.