Provider Signatures

YFarroyo

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Hello all, would providers be able to sign off on other providers' nurse visit documentations? For example, patient came in for injections in which the nurse administered. The nurse visit documentation uploaded is under provider A, and signed by provider B on behalf of provider A. Is that a valid signature? I read the CMS signature guideline but I am confused if this scenario is not allowed or not. Thank you!
 

thomas7331

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I don't think there is any CMS requirement that providers must 'sign off' on nurses' documentation. The doctors must write and sign a valid order for anything that a nurse performs, but only the nurse is require to sign their own documentation since they are the ones performing the service. I know that some organizations may require the MD to sign the nurses' documentation, but I don't believe it is a CMS requirement. Nurse visits must meet all the 'incident to' requirements, but having the provider sign the documentation is not one of these.
 

YFarroyo

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I don't think there is any CMS requirement that providers must 'sign off' on nurses' documentation. The doctors must write and sign a valid order for anything that a nurse performs, but only the nurse is require to sign their own documentation since they are the ones performing the service. I know that some organizations may require the MD to sign the nurses' documentation, but I don't believe it is a CMS requirement. Nurse visits must meet all the 'incident to' requirements, but having the provider sign the documentation is not one of these.
In the clinic I work for, all nurse visit documentations are signed by a provider. I would assume that the ordering would have to be the one to sign off on the nurse visit documentation and not another provider. These providers are all in one department. Is it okay for another provider to sign the ordering provider's nurse visit documentation? Thank you so much for your response.
 

thomas7331

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In the clinic I work for, all nurse visit documentations are signed by a provider. I would assume that the ordering would have to be the one to sign off on the nurse visit documentation and not another provider. These providers are all in one department. Is it okay for another provider to sign the ordering provider's nurse visit documentation? Thank you so much for your response.
Since this is a requirement within your organization, I think you'd need to direct this question to someone in your clinic's management or compliance areas. In my experience, CMS and other payers are mainly concerned that the orders are valid and signed, and that the nurse or other staff member documented that they completed the task as ordered. A provider signature on a nurse's note is pretty much meaningless - all it tells payers is that the provider looked at the note and put their name on it. In my opinion it's a waste of providers' time, and I've never come across a payer policy that says this has to be done.
 

YFarroyo

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Since this is a requirement within your organization, I think you'd need to direct this question to someone in your clinic's management or compliance areas. In my experience, CMS and other payers are mainly concerned that the orders are valid and signed, and that the nurse or other staff member documented that they completed the task as ordered. A provider signature on a nurse's note is pretty much meaningless - all it tells payers is that the provider looked at the note and put their name on it. I've never come across a payer policy that says this has to be done.
That is very helpful information. Thank you! :)
 
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