C-11-321 Orders Management: Provider Signature Tip Sheet
👤ROLE
Medical Records Specialist
🎯 PURPOSE
Provides an additional resource for order review and follow-up. Included are the defining criteria for valid provider signatures, specific examples of acceptable and unacceptable signatures, and examples of verbiage to use when following up on provider signatures.
🔄 PROCESS
The process below includes the following sections:
Signature Criteria
This section provides defining criteria for acceptable or unacceptable provider signatures.
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If the order is electronically signed, it must be an acceptable form of an electronic signature.
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This is an example of an acceptable electronic signature.
Acceptable electronic signature. -
This is an example of an unacceptable electronic signature as it is clearly just typed.
Unacceptable signature - See below for additional examples of electronic signatures.
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- If the physician/NPP signature is electronic, the date must also be electronic.
- If the physician/NPP signature is handwritten, the date must also be handwritten.
- The date must be legible, accurate, and must include month, day and year.
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For example, this signature is unacceptable as there is no date.
Unacceptable signature -
This is and example of an unacceptable signature as the date is missing the year. Dates must be complete (mm/dd/yy):
Unacceptable signature due to unacceptable date. -
In this example, the order was signed in 2020 but the year is listed as 16. This would be an unacceptable order due to the incorrect year.
Unacceptable signature due to incorrect date.
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For additional reference, here are some additional guidelines from the Center for Medicare and Medicaid Services (CMS) regarding signature requirements:
Electronic Signature Examples
These signatures are or are not acceptable for the following reasons:
| Signature Example | Acceptable or Not Acceptable? - Reason |
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Acceptable. The provider’s name, “digitally signed” verbiage, and the date/time stamp are legible and accompany the electronic signature. |
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Acceptable. This signature is acceptable because of the footer at the bottom of the page which reads “Updox e-Sign…” followed by a legible reference number and timestamp. This demonstrates that the electronic signature/date has been applied to the order using an e-signature software. |
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Acceptable. This has been confirmed as a type of electronic signature utilized by the Veterans’ Administration. Verbiage stating “Approved by” instead of “Digitally signed by” is acceptable for this type of signature only. The physician’s name and NPI must also be legible. |
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Not acceptable. In this example, a provider is listed on the left side of the signature certificate as “Signer”. However, in the signature field it is indicated that a different individual is signing on behalf of the provider listed as “Signer” – the provider listed as “Signer” did not in fact sign this order. Because of this discrepancy, this digital signature certificate is not acceptable. |
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Not acceptable. The provider has signed with a date beside the digitally captured signature – the date conflicts with the date 3/26/24 on the timestamp, creating a discrepancy that makes the signature unacceptable. |
Signature Follow-Up: Helpful Verbiage
Here is some verbiage which may be helpful to reference when following up on orders.
General Signature Requirements Verbiage
“Per the Medicare Benefit Policy Manual Chapter 7 - Home Health Services, Section 30.2, CMS defines provider signature requirements for home care.”
Then as applicable, insert statement (a) or (b) from the specific verbiage below.
Specific Verbiage
a) Example: If the signature/date is simply typed without indicating it is an electronic signature (not an acceptable electronic signature).
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Statement to use: “Unacceptable forms of signature include a digitally appended (typed) provider name which does not indicate it is an electronic signature.”
Example of unacceptable electronic signature. 
Example of unacceptable electronic signature.
b) Example: If the signature is handwritten but the date is typed.
- Statement to use: “Unacceptable forms of signature include a handwritten signature with a digitally appended (typed) date.”
📅 Effective: 11.04.2024  | 🛠️ Revised: 07.13.2026 |  ✅ Approved: JFJ