Patient sign in.


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I hope that I've picked the right forum. Our office often has returning patients and unless they have a co-pay or out of pocket expense where a receipt is generated and signed we don't have a sign in process.
Of course the medical documentation is there but I'm concerned that we really need to have a patient signature for each visit.
Either way, could you please direct me to a resource that addresses this? Thanks in advance.


True Blue
Local Chapter Officer
Modesto, CA
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Per Medicare the scope of the duration of a patient signature authorization is as follows:

1.A provider may obtain a lifetime authorization from the beneficiary to submit assigned and nonassigned claims on the beneficiary’s behalf. Providers must maintain these signatures on file as they are subject to audit verification.

2.A hospital or other provider may obtain a beneficiary authorization, effective for the period of confinement, for the provider to submit assigned and nonassigned claims for services furnished on an inpatient basis

3.A hospital or other provider may obtain a lifetime beneficiary authorization for outpatient care for providers and for the physicians submitting assigned and nonassigned claims

4.A provider who submits a claim for diagnostic tests or test interpretations may sign the claim on behalf of the beneficiary if the beneficiary is not physically present for the services. If paper claims are used, indicate 'Patient not physically present for services' in Item 12 of the CMS-1500 claim form. Submit information in the appropriate record for electronically submitted claims. This does not apply to services furnished in a medical facility that is visited by the patient or whose representative visits the patient.

5.If someone other than the Medicare beneficiary signs the claims form, the relationship between the requestor and the beneficiary and the reason the beneficiary was unable to sign must be indicated

Note, some offices have the patient sign each time they are seen and some offices allow for the lifetime authorization as noted above. A sign in sheet does not apply in these cases as the sign in sheet does not normally have any indication that the patient is authorizing or submitting to services.

CMS Medicare Claims Processing Manual, (Pub. 100-04), chapter 1, section 50.1.3
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In addition to the previously mentioned auth forms...

When the patient arrives, I assume they check in at the desk...? Usually the receptionist (or equivalent) will ask if their info has changed, ect, document the sign in, and the system should note the date and time, I'd assume.

Certainly the patient could claim they weren't there that day, however if medical documentation is created and the provider signs off on it, it becomes a legal document. The attestation by the provider would be sufficient to prove the patient was present, unless the provider is.... "shady" so to speak. If something was brought to court by the patient, you'd have the documentation from the person who checked the patient in, the MA/RN/etc would also likely have documentation of the vitals and so forth, and then the provider's encounter note. It would be one uphill battle for a patient to win a case with that amount of legal paperwork and number of "witnesses", if you know what I mean.

The only exception would be if someone came in pretending to be said patient, in which case the provider would not be liable for a third party stealing someone's identify so long as they had no knowledge of it. This could easily be prevented by checking a patient's photo ID during check in.