Wiki Medical Records Requirements

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Hi,

I was wondering what the CMS guidelines are as to how long after services were rendered a provider can sign his notes and if the providers credentials are needed with the signature. I just received a refund request from Health First because the doctor signed his notes 3 days after the services were rendered and his credentials are missing.

Any help would be greatly appreciated!

Thanks in advance!
 
CMS does not dictate any specific amount of time after which a signature is no longer acceptable, nor does it specifically require credentials. Are they really recovering funds due to this? This sounds completely unreasonable. I would have a very frank conversation which someone at this payer and if they're really serious about this, I think I would probably advise my providers not to do business with them.

Here is a good publication that summarizes CMS signature requirements:
 
CMS does not dictate any specific amount of time after which a signature is no longer acceptable, nor does it specifically require credentials. Are they really recovering funds due to this? This sounds completely unreasonable. I would have a very frank conversation which someone at this payer and if they're really serious about this, I think I would probably advise my providers not to do business with them.

Here is a good publication that summarizes CMS signature requirements:
The insurance is asking for the full refund which is close to 13k.
 
The insurance is asking for the full refund which is close to 13k.

I would recommend reviewing your contract with the payer (if you have one) and the payer's reimbursement policies. If there is no mention of this requirement in any of these documents, then you can certainly fight this. For that amount of money, it might be worthwhile to consider having a lawyer get involved to advise if you are legally required to refund this payment and/or to help draft a formal response.
 
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