Wiki Attestation page

[KMayercsik]

Hi all!
I was recently denied on an appeal to Highmark Medicare because of an illegible signature. It did not meet the requirements as outlined in the CMS manual. Has anyone done an attestation page for the patient chart for multiple providers? I would really like to view one so I can have an idea of how to incorporate one for our patient charts.
Fax: 302-875-5713 or kmayercsik@comcast.net
Thanks!

 

[j.berkshire]

See this MLN Matters article with an example of an attestation statement on page 4: http://www.cms.gov/MLNMattersArticles/downloads/MM6698.pdf