Wiki Signature

[sherriev]

If a provider note is not signed, is it ok to submit a claim (with the expectation that it will be signed)?

 

[WaterJunkie]

Hello. No. The submitted claim must be supported by the documentation. If the report is not signed, the claim is not billable. The supporting documentation must be signed and finalized prior to payer submission.

 

[sherriev]

Thank you. I agree 100%. Do you know where I can find anything that actually says that the signature has to be there before submitting? I've looked everywhere I can think of. CGS (our MAC) says it it highly recommended before submitting claims. I've stated the note is incomplete and should not be billed. I've stated that there is no way to know the note will actually be signed. I'm being advised that there is nothing wrong with "submitting" the claims. Notes will be signed sometime after that and will be verified prior to sending documentation anywhere.

 

[Mayzoo]

If it is an E/M visit, then without the signature of an authorized provider, all you can bill for is a 99201 (99211), nurse visit.

 

[thomas7331]

Thank you. I agree 100%. Do you know where I can find anything that actually says that the signature has to be there before submitting? I've looked everywhere I can think of. CGS (our MAC) says it it highly recommended before submitting claims. I've stated the note is incomplete and should not be billed. I've stated that there is no way to know the note will actually be signed. I'm being advised that there is nothing wrong with "submitting" the claims. Notes will be signed sometime after that and will be verified prior to sending documentation anywhere.

Here is a link to a good CMS publication regarding the signature requirements:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Signature_Requirements_Fact_Sheet_ICN905364.pdf

 

[thomas7331]

If it is an E/M visit, then without the signature of an authorized provider, all you can bill for is a 99201 (99211), nurse visit.

99201 is not a nurse visit - it requires a face-to-face by the provider. In any case, billing a nurse visit for a provider's unsigned note is not the correct way to handle this because that would misrepresent the service actually performed - the record should be sent back to the provider for authentication and then billed correctly.