Wiki Hypothetical Question Concerning a Signature Date on a Medical Order

[khartoum1900nile@aol.com]

I submitted a Medicare Redetermination, and it was denied because the signature date on the Oxygen CMN was outside of the allowed 30 days after the face-to-face visit. Then all of a sudden, the signature date was changed from September to July to meet the 30-day signature date requirement for Medicare. It is now being treated as the new order and the one with the September signature date has been deleted from the record. I would be afraid to do a Reconsideration because it was denied for the signature date. I would be afraid to speak up about this to the higher-ups. Maybe I'm overthinking this because I know if a Reconsideration was submitted with the new order and I were the Reconsideration panel, I would question this.

 

[thomas7331]

I submitted a Medicare Redetermination, and it was denied because the signature date on the Oxygen CMN was outside of the allowed 30 days after the face-to-face visit. Then all of a sudden, the signature date was changed from September to July to meet the 30-day signature date requirement for Medicare. It is now being treated as the new order and the one with the September signature date has been deleted from the record. I would be afraid to do a Reconsideration because it was denied for the signature date. I would be afraid to speak up about this to the higher-ups. Maybe I'm overthinking this because I know if a Reconsideration was submitted with the new order and I were the Reconsideration panel, I would question this.

You have valid concerns here - signature dates can't be retroactively changed, and Medicare also does not allow late signatures on orders. Doing so would be falsification of the record and if this is done in order to obtain payment, then that is potential fraud. I'm not sure how this would happen - electronic records systems are able to track any changes that are made, so unless your orders are entirely on paper, then there will be a record of who made this change and when.

In your situation, I would be reporting this to my compliance department to review. It's understandable that you may not feel comfortable speaking to your management about this, but most compliance programs include a means for anonymous reporting of concerns. Also keep in mind that it would be illegal for your employer to retaliate against you for bringing up these concerns.

 

[khartoum1900nile@aol.com]

Thank you. As for the order in question, it's a paper order.