Signed Agreement from Physician


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I am looking for a copy of a letter or form. This is for clinic practice only, not Hospital. In several previous practices there was a letter signed by every Provider (MD, PA, NP, Nurse) that would be documenting in the EHR and services would be billng out under their name.

The letter was part of the Physician in-processing paperwork that had to be signed. The letter/form acknowledged that certified coders would review their documentation and coding could or would be changed based on their documentation. The signed letter was acknowledgement and agreement of this process.

This allowed the claims to bill out coded correctly, eliminated the repetitive notices sent to the providers and trends would be discussed during scheduled education sessions.

Does anyone have a form of this type? Anyone see any problems with the use of this form?