Chiropractic Signatures and Authentication

Signature Rules for Chiropractic Documentation Can Be Confusing

Chiropractors agree the documentation training they received in chiropractic college was not enough. Many chiropractors don’t realize that even if you are the only doctor in your chiropractic practice, you have to sign each note for each date-of-service, to show you were the doctor who performed those services.

What Is Required for a Valid Signature in My Chiropractic Documentation?

According to Medicare^*: For a signature to be valid, the following criteria must be met: Services that are provided or ordered must be authenticated by the ordering practitioner; signatures are handwritten, electronic, or stamped (stamped signatures are only permitted in the case of an author with a physical disability who can provide proof to a CMS contractor of an inability to sign due to a disability); and signatures are legible. Did you know, both your notes AND your signature must be legible? Most chiropractors don’t know illegible signatures can stop you from getting paid!

But My Chiropractic Signature Is Illegible

What can you do, if your signature is NOT legible; now that you know illegible signatures are not acceptable? What can you do about your prior notes with an illegible signature? There are steps you can take to remedy your current signature problem and proactive steps for future signatures with a signature log. According to CMS, you may submit a signature log or attestation statement to support the identity of the illegible signature. If the original record contains a printed signature below the illegible signature, this may be accepted. This simple, effective and little-know process is one of the dozens of lessons contained in the chiropractic documentation section of the KMC University Library.

*Reference: CMS “Medicare Program Integrity Manual” (Publication [Pub.] 100-08), Chapter 3, Section 3.3.2.4 at http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/pim83c03.pdf  on the CMS website.

Back to: Chiropractic Documentation Basics