- Avoid Processing Delays by Following Proper Submission Guidelines
- Medicare Beneficiary Eligibility Checklist
- Acceptable Electronic Signatures Reminder
- Capable Recipients for the Advance Beneficiary Notice of Noncoverage
- Hospital-Issued Notices of Noncoverage
- Medicare Advance Written Notices of Noncoverage Booklet
- Primary Care Exception Guidelines
- Ordering DMEPOS Items
- Appropriate Use Criteria Program
- Assistant at Surgery Billing Documentation Reminder
- Avoid Return to Provider and Claim Rejections-Enhancing the Beneficiary Eligibility Verification Process
- Checking Eligibility and Knowing Your Point of Contact
- Cloned Documentation Could Result in Medicare Denials for Payment
- Documentation Reminder: Psychiatry and Psychology Services
- Documentation Required for Home Visits
- Electrical Stimulation Therapy: Important Coverage and Documentation Reminders
- Go Paperless Today - Protect Your Bottom Line
- Hospital Acquired Conditions and Present on Admission Resource for Physicians
- Inpatient Admission Prior to Medicare Entitlement Job Aid
- MDS Calendar
- Medicare Home Health Collaboration with Other Provider Types
- Part A Claims for High Cost Items and Certain Drugs Requiring Additional Information
- Manual Review of Claims for Replacement of Supplies and Accessories used with External Ventricular Assist Device
- Referring, Monitoring and Certifying Home Health Services
- Scribing Medical Record Documentation
- Skilled Nursing Facility Medicare Part A Benefit Quick Reference Fact Sheet
- Submit Medical Record Documentation Electronically
- Submitting Electronic Medical Records via CD-ROM
- Using the Medicare Part B PWK Fax-Mail-esMD Cover Sheet
Acceptable Electronic Signatures Reminder
Table of Contents
Acceptable Electronic Signatures Reminder
CMS issued CR6698 to clarify how Medicare claims review contractors review claims and medical documentation submitted by providers; this includes EHR. The previous language in the CMS IOM Publication 100-08, Medicare Program Integrity Manual required a legible identifier for services provided/ordered. The method used shall be handwritten or an electronic signature (stamp signatures are not acceptable) to sign an order or other medical records documentation for medical review purposes.
MLN Matters MM6698: Signature Guidelines for Medical Review Purposes revised the CMS IOM Publication 100-08, Medicare Program Integrity Manual, Chapter 3, Section 3.3.2.4 and the current language requires that services provided/ordered be authenticated by the author. The manual was revised to include examples of handwritten signatures and an example of an attestation statement, but no examples of electronic signature.
Examples of Acceptable Electronic Signature
- Chart “Accepted by” with provider’s name
- “Electronically signed by” with provider’s name
- “Verified by” with provider’s name
- “Reviewed by” with provider’s name
- “Released by” with provider’s name
- “Signed before import by” with provider’s name
- Digitized signature: Handwritten and scanned into the computer
- “This is an electronically verified report by John Smith, MD”
- “Authenticated by John Smith, MD”
- “Authorized by: John Smith, MD”
- “Digital Signature: John Smith, MD”
- “Confirmed by” with provider’s name
- “Closed by” with provider’s name
- “Finalized by” with provider’s name
- “Electronically approved by” with provider’s name
When you submit medical records to a Medicare contractor with an electronic signature, you must also include a copy of the electronic signature protocol/procedure. The protocol/procedure should describe the requirements that the physician uses his own ID and password to enter the system to sign the medical records. The Medicare contractor will keep a copy of the protocol/procedure on file for each provider for future documentation request, so only one copy will need to be submitted.
Examples
The electronic signature is not dated and does not identify the physician:
- Plan of care is reviewed and discussed with nursing staff
- Author: nurse – physician (e-signed)
The electronic signature does not identify the physician:
- Monitor closely
- Author nurse – physician (e-signed)
- Date: 3/10/2019
Revised 11/6/2023