Information Needed

coder21

Guru
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Can someone tell me where I can find documentation stating that before the claim goes to the insurance company the chart needs to be signed off on?

Thank you
 

ckmiotek

New
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Tampa, FL
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If you got to this link:
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/CERTMedRecDoc-FactSheet-ICN909160.pdf

One the bottom of the second page is states:
"Claims are determined to have insufficient
documentation errors when the medical
documentation submitted is inadequate
to support payment for the services billed
(that is, the reviewer could not conclude that
some of the allowed services were actually
provided, were provided at the level billed,
and/or were medically necessary). Claims are
also placed into this category when a specific
documentation element that is required as
a condition of payment is missing, such as
a physician signature..."

I am going to assume that when you say "signed off on" you mean the doctor has signed off on the chart for that days visit. We utilize an EMR and we can not bill any claims until the doctor has signed off and closed the encounter. It gets a bit frustrating when he is behind and hasn't signed off on some old ones. The good thing is that the EMR shows those open encounters first in red bold to remind the doctor finish these firsts.
I hope this answered your question.
 

coloradopa

Networker
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Georgia
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Can someone tell me where I can find documentation stating that before the claim goes to the insurance company the chart needs to be signed off on?

Thank you
Our coders won't send a bill out until the note is finalized. The reasoning is that the chart can change before its finalized. Is there a rule against sending out a bill based on an unsigned note - probably not. Is it good practice - no.
 
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