Next to me on my desk is my wallet (I see you coming up behind me – BACK OFF!). I’m reaching in and randomly pulling out four items. First, there’s my driver’s license (the fact that I have one that has yet to be revoked will probably come as a shock to those who have actually seen me drive). On the bottom left hand corner of my license is my signature, making it official.
Next comes my bank-issued debit card. Turning it over, I again note my signature, allowing me to complete purchases out in the Great Beyond. Next comes my supermarket savers club card (the one that tracks my continuing purchase of junk food that gave me the two chins I’m sporting on the aforementioned driver’s license). I turn it over, and even this card has a signature block, which is used to verify signature in the event I feel like writing a check at the supermarket (I’m a man; I never do). Finally, I have my major credit card, complete with self-selected hockey theme on the front and yes, my signature on the back, making it official.
If I am out about town and I want to complete a monetary transaction without cash, it becomes imperative that my signature be on all of the items above. Now take this idea for a moment and expand it to a handwritten medical record.
When a medical claim is submitted to an insurance provider, what a physician is telling the payer is that the form he or she has submitted for reimbursement is a numerical representation of a medical record in the physician’s possession that justifies the billing. However, if that medical record lacks the physician’s signature, what is being submitted for payment is invalid.
While the first and foremost responsibility of any physician is the care and well-being of his or her patient population, there must be a constant awareness that every patient who presents for care represents a compensation opportunity. The easiest action to take to ensure that any one opportunity doesn’t slip through the physician’s fingers is the placing of a signature on every medical record.
Beginning in 2011, Medicare will begin to pay nominal bonuses for the meaningful implementation of an electronic medical record. While that time is virtually right around the corner, the reality is that there are many physicians who currently utilize a handwritten medical record for their patients. Without a physician signature on those medical records, it is as if the services being documented never existed. When it comes to claims appeals, lack of signature on a medical record gives your claims appeal the life expectancy of a deer wearing a bell around its neck during hunting season.
Signing a handwritten medical record should be viewed just like a check or a credit card; without a signature, a transaction won’t occur. To put it in colonial terms, if I don’t have a John Hancock, I can’t buy a 12-pack of Samuel Adams (why did an idea for the weekend just pop into my head?). Similarly, if a doctor doesn’t have a John Hancock, the Benjamin Franklins won’t be showing up.