Wiki Using Signature date as Date of Service.

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despinoza

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Could anyone please help me... I am being told that I need to use the signature date as the date of service. When I reviewed the chart, I can clearly see the date of service in which the electronic signature is attached to. The signature is date and time is for the following date. I don't agree with this. I tried looking up on CMS.gov to find something to reference but I did not find anything. I just want hard concrete to show them. I know most payors will not accept this as the DOS and I also know that the provider could of signed off the next day. But they are not budging to that. If you could please help me with references to show them. I would appreciate it .

TIA. :)
 
My goodness, you don't need documentation from CMS to know that the date of service has to be correct. You've said that the date of service is clearly in the record and does not match the signature date, so you've done your job here in showing them that this is incorrect information that is going on the claims. If the providers have any doubt, they can just look at the appointment calendar to see the actual date the patient was seen.

CMS rules (and federal laws) are that claims need to be correct, accurate and supported by documentation. If someone doesn't have the sense to see that something as basic as this is creating an inaccurate claim, I don't think that there's much more you can do no matter how many references you try to find for them.

Sorry if this isn't more helpful, but it just seems to me to be plain common sense. It never ceases to amaze me that coders who are trying to do their job correctly are subjected to things like this by providers and practice managers so often.
 
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I'm screaming. The date of service is the date the services were provided. This is common sense. What are the providers' justification for this?? This is fraud, do they want all their payments reversed when Medicare realizes their documentation doesn't match the DOS? Because that's how you get all your payments reversed. And probably fines.

Can you contact your local MAC and see if they can educate the providers?
 
thomas7331 said:
My goodness, you don't need documentation from CMS to know that the date of service has to be correct. You've said that the date of service is clearly in the record and does not match the signature date, so you've done your job here in showing them that this is incorrect information that is going on the claims. If the providers have any doubt, they can just look at the appointment calendar to see the actual date the patient was seen.

CMS rules (and federal laws) are that claims need to be correct, accurate and supported by documentation. If someone doesn't have the sense to see that something as basic as this is creating an inaccurate claim, I don't think that there's much more you can do no matter how many references you try to find for them.

Sorry if this isn't more helpful, but it just seems to me to be plain common sense. It never ceases to amaze me that coders who are trying to do their job correctly are subjected to things like this by providers and practice managers so often.
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Thank you so much. It as clear as it can be. I even found their SOP to be contradicting. I even asked them to show me a reference where it indicates to use the signature stamp as the DOS. I got Audited and it was considered a defect. I ate it and billed it out the way it should be. I know better myself. This was for an Observation Split-Service with an APP. I also have experience in Risk Adj. as well as an Auditor but that's not my title. It amazes me that an Auditor told me this a (CPC). I rebutted and forward it to my Lead who is also a (CPC). 🤨 I even advised to query the provider. The provider put their note and a specific DOS and if it was the wrong DOS it can be corrected. I'm just the CODER I am told. But we all are.. We are all CPC's and you are still telling me incorrect.
 
thranowski said:
I'm screaming. The date of service is the date the services were provided. This is common sense. What are the providers' justification for this?? This is fraud, do they want all their payments reversed when Medicare realizes their documentation doesn't match the DOS? Because that's how you get all your payments reversed. And probably fines.

Can you contact your local MAC and see if they can educate the providers?
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The company has Provider Educator. I used to educate provider at my previous employment. I send it off to Compliance within the company b/c I didn't agree with it.
 
despinoza said:
Thank you so much. It as clear as it can be. I even found their SOP to be contradicting. I even asked them to show me a reference where it indicates to use the signature stamp as the DOS. I got Audited and it was considered a defect. I ate it and billed it out the way it should be. I know better myself. This was for an Observation Split-Service with an APP. I also have experience in Risk Adj. as well as an Auditor but that's not my title. It amazes me that an Auditor told me this a (CPC). I rebutted and forward it to my Lead who is also a (CPC). 🤨 I even advised to query the provider. The provider put their note and a specific DOS and if it was the wrong DOS it can be corrected. I'm just the CODER I am told. But we all are.. We are all CPC's and you are still telling me incorrect.
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If your company has a policy to do it this way, then of course the coders and auditors are going to be following that policy and will cite an error if you don't follow it. I think most coders who've worked for large organizations for any length of time have probably encountered policies they don't completely agree with (there are times where I don't agree with CMS policies, let alone my employer's!) but sometimes you have to accept these. As long as you have written guidance from your employer, and as long as you're not actively participating in a fraudulent scheme to get payments that you're not entitled to, you can go along with the policies - it's the employer that's going to be responsible for their policies, not you for following them.

But if you've referred this to compliance, you've definitely done the correct thing - this sounds incorrect and they need to look at it, and escalating it through the proper channels is the best way to address it. They should give you their written response to your concerns (ask for one if they don't), and you can keep a copy of that in the event that you're ever questioned for doing what they've instructed.
 
I don't envy you. Can you imagine the auditing nightmare when Medicare or another insurance company gets a bill for surgery on May 1, for example, and the patient calls them and says "I didn't have surgery on May 1" (yes, I'm that kind of patient) and the ins asks for the medical records for DOS May 1, and there is none? Yikes. What a can of worms that will open.
 
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