Home Health & Hospice

Q: A physician we work with designated someone to sign his name for him while he was out. Can we accept this signature because he gave permission to someone else, or must we reject the signature

Homecare Insider, June 3, 2013

Q: Our nursing supervisor noticed that a particular physician's signature suddenly changed from what she describes as "hieroglyphics" to a legible and readable name. She called the physician's office and discovered that someone in the office was designated to sign his name for him while he was on a month-long vacation. Can we accept this signature because he gave permission to someone else, or must we reject the signature?

A: Unfortunately, no, you cannot accept that signature. It must be the physician's signature on the plan of care. Many agencies have incurred technical denials when the intermediaries determined that it was not the physician's signature on the plan of care. It's important that in situations like this, where someone detects a radical signature change, action is taken.

Change Request 6698 has tightened the medical review policies on signatures, both for physicians and for any other clinician providing services that are billed. The guidance states that upon an audit, the reviewer should be able to authenticate all signatures.

This means the signature is either:
  • Legible;
  • Accompanied by identification next to it;
  • Verified by a signature log; or
  • Verified by an attestation statement.

In the busy world of homecare, it can be easy to accept any documentation you can get. Despite the time constraint to get this information, agencies must ensure that they are ­compliant including signatures.

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