Is Your Signature Legible?

The first piece of education reviews the basic Center for Medicare & Medicaid Services (CMS) requirements for authentication of services provided or ordered. When CMS reviewed numerous examples of CERT signature denials, they found in almost every instance that the documentation was acceptable. Services were denied because of one of four “not acceptable” signature reasons, including

1. Illegible, unrecognizable handwritten signature or initials
2. Unsigned “typewritten” progress notes with a typed name only
3. Unverified or unauthorized electronic signatures
4. No indication of the rendering physician/practitioner

The Palmetto GBA Medical Directors strongly encourage the following improvements

1. Be sure a handwritten signature is a mark or sign by an individual on a document to signify knowledge, approval, acceptance or obligation
2. Records should clearly indicate they have been “electronically signed by” and include a date/time, including verbiage that makes this clear
3. Establish a protocol to ensure valid signatures are affixed to every order, record, or report within a reasonable time frame (i.e., customarily 48-72 hour after the encounter – but certainly before the claim is submitted to CMS for payment)

Additional information about the CERT program is available on the Palmetto GBA website under the CERT link. This focus is likely to apply to other intermediaries soon, so watch for additional educational updates and start looking into your current processes.

2 thoughts on “Is Your Signature Legible?

  1. Gail,

    Great post. Short and to the point. I could not find the CERT link on the Palmetto GBA page. Could you provide it here in the comments or put it in the original post?

    Found an interesting post about chicken scratch and the history pf physician hand writing. Here is the conclusion:

    “Chicken scratch, cacography, scrawl, hieroglyphics, ‘the dance of an inked chicken on meth’ (Ostrom, 2006); physician handwriting has been called many things, but the bottom line is that it is a product of the profession of medicine and the expectations of patients that can have deadly consequences.”

    Full text pdf can be found here.

  2. Thanks, Christian. The CERT link is deeply buried on the Palmetto website. It’s actually under “Jurisdiction 1” – California and Nevada, I think, if my geography doesn’t fail me (there’s only a map and no names that I could find…)

    Anyway. Here’s the link:

    And here’s the link to the CERT provider:

    Hey! I LIKE this blogging stuff!

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