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welcome to the signature requirement tutorial this presentation discusses the purpose of signature requirements and what those requirements are my name is Tracy shot with the provider outreach and education team at Meridian health care solution the information presented here is current as of this recording but Medicare changes often so be sure to check the CMS and yridian website for any update the agenda includes an overview of signature requirements and the reason signatures are looked at closely what is considered a valid and acceptable signature a review of the signature log and attestation statement and when these are needed and will follow up with resources in this first section I'll go over what's considered a valid signature for medical review purposes Medicare requires that services provided and ordered be authenticated by the author the method used shall be a handwritten or electronic signature stamps signatures are not acceptable with one exception that I'll discuss in an upcoming slide the CMS rules pertaining to signatures apply to all providers and suppliers of Medicare services any medical record submitted to Medicare for review must contain a valid signature there are four exceptions to the signature requirement when reviewing medical documentation exception one faxes of original written or electronic signatures are acceptable for certifications of terminal illness for hospice exception two there are some circumstances when an order does not need to be signed such as orders for some clinical diagnostic tests if the order for one of these tests is unsigned there must be medical documentation by the treating physician that he or she intended the test be performed this documentation showing the intent must be authenticated by the author exception 3 for medical review purposes if the relevant regulation such as the national or local coverage determination is silent on whether the signature needs to be legible or present and the signature is illegible or missing the reviewer shall follow the signature guidelines in cases where the relevant regulation has specific signature requirements those signature requirements take precedence and exception for CMS would permit use of a rubber stamp for signature in the case of an author was a physical disability that can provide proof to a CMS contractor of his or her in ability to sign their signature due to their disability the first acceptable signature is a handwritten one a handwritten signature is a mark or sign by an individual that signifies knowledge approval acceptance or obligation electronic signatures are another acceptable format and listed here are acceptable examples a full listing is provided in change requests or CR six six nine eight the signature must also show the date and time before submitting records to a review entity ensure the documentation has been signed by the provider submit final copies and not preliminary or draft copies of documentation and indications that a document has been signed but not read are not acceptable with electronic signatures be sure the system and software products chosen are protected against...