FIELD 31- Signature of Physician or Supplier Including Degrees or Credentials
The “Signature of the Physician or Supplier Including Degrees or Credentials” refers to the authorized or accountable person and the degree, credentials, or title.
NUCC INSTRUCTIONS: “Signature of Physician or Supplier Including Degrees or Credential” does not exist in 5010A1.
Enter the legal signature of the practitioner or supplier, signature of the practitioner or supplier representative, “Signature on File,” or “SOF.” Enter either the 6-digit date (MM|DD|YY), 8-digit date (MM|DD|YYYY), or alphanumeric date (e.g., January 1, 2003) the form was signed.
MEDICARE INSTRUCTIONS: Enter the signature of provider of service or supplier, or his/her representative, and either the 6-digit date (MM | DD | YY), 8-digit date (MM | DD | CCYY), or alpha-numeric date (e.g., January 1, 1998) the form was signed.
In the case of a service that is provided incident to the service of a physician or non-physician practitioner, when the ordering physician or non-physician practitioner is directly supervising the service as in 42 CFR 410.32, the signature of the ordering physician or non-physician practitioner shall be entered in item 31. When the ordering physician or non-physician practitioner is not supervising the service, then enter the signature of the physician or non-physician practitioner providing the direct supervision in item 31.
NOTE: This is a required field; however, the claim can be processed if the following is true: if a physician, supplier, or authorized person's signature is missing, but the signature is on file; or if any authorization is attached to the claim or if the signature field has "Signature on File" and/or a computer generated signature.
Related Articles
Field 13 - Insured’s or Authorized Person’s Signature
The “Insured’s or Authorized Person’s Signature” indicates that there is a signature on file authorizing payment of medical benefits. NUCC INSTRUCTIONS: Enter “Signature on File,” “SOF,” or legal signature. If there is no signature on file, leave ...Field 12 - Patient’s or Authorized Person’s Signature
The “Patient’s or Authorized Person’s Signature” indicates there is an authorization on file for the release of any medical or other information necessary to process and/or adjudicate the claim. NUCC INSTRUCTIONS: Enter “Signature on File,” “SOF,” or ...FIELD 27- Accept Assignment?
The accept assignment indicates that the provider agrees to accept assignment under the terms of the payer’s program. NUCC INSTRUCTIONS: Enter an X in the correct box. Only one box can be marked. Report “Accept Assignment?” for all payers. MEDICARE ...Field 19 - Additional Claim Information (Designated by NUCC)
“Additional Claim Information” identifies additional information about the patient’s condition or the claim. NUCC INSTRUCTIONS: Please refer to the most current instructions from the public or private payer regarding the use of this field. Report the ...Field 9 - Other Insured's Name
The “Other Insured’s Name” indicates that there is a holder of another policy that may cover the patient. NUCC INSTRUCTIONS: If Item Number 11d is marked, complete fields 9, 9a, and 9d, otherwise leave blank. When additional group health coverage ...