Failing to validate compliant and accurate signatures on medical records and prescriptions is a very serious concern. CMS has established very specific regulations and rules for provider signature requirements and appropriate medical record maintenance and documentation. Failure to follow the guidelines will lead to potential fines, penalties, and even exclusion from participation in government programs. Strict guidelines have been established to mandate the presence of signatures for the medical review process. It is critical to ensure that all providers are compliant with their medical record documentation and it is vital for your staff to understand the importance of these signature requirements, Exceptions to the signature requirement, Timeliness/Dating issues, and much more. You also need to have in-depth knowledge of creating and identifying a “legal medical record” along with other RAC/MAC Identified areas of audits.

Agenda:-

The following agenda will be discussed in detail during this session : 

• Latest CMS Signature requirements for Medical Review process
• Hand-written vs Electronic signatures
• The importance of Timely Documentation and Signatures
• Case Studies and Examples for Valid Signatures vs Records with Signature Errors
• Importance of accurate medical record documentation - Reimbursement process & continuity and quality of care
• Identifying the "legal medical record”
• Special CMS Documentation Requirements for H&Ps, progress notes, and discharge summaries
• Outlining RAC/MAC identified Issues
• Discussing the importance of compliance
• Facilitating Provider Education