Urology Coding Alert

Question: Most of our physicians are very cooperative about all of their documentation, but I have trouble getting a few of them to sign their claim forms. Some have even asked if I can get them a signature stamp to save time. What should I tell these physicians?

Minnesota Subscriber

Answer: When a physician provides a medical service for a patient, he or she must include either a handwritten or electronic signature in order to authenticate that fact. That is what you need to tell your physicians.

Consequences: If you submit claims without a signature that passes muster with the payer, you could be in for denials. If payers detect a consistent pattern of signature-deficient claims, you could potentially face much worse penalties.

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 permits her from providing a signature. In these cases, the provider can use a stamped signature if she “can provide proof to a CMS contractor of an inability to sign due to a disability,” CMS reports.
• Be legible.

E-signature caveat: 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 stiff enough to correspond with any current signature laws on the books.

Remember: When you use an electronic signature, “the individual whose name is on the alternate signature method and the provider bear the responsibility for the authenticity of the information being attested to,” CMS warns.

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.

In an effort to make the signature process more streamlined, Medicare does allow practices to keep a “signature log” on file for signing documents.

Definition: A signature log is a typed list of all of your practice’s healthcare providers, which includes their names and a corresponding signature. “A signature log may be used to establish signature identity as needed throughout the medical record documentation,” CMS states.