Box 31 is for the provider’s signature. In effect, your signature is making the claim that all the charges are true and accurate. There are 4 options in this box.
•Digitized is the usual choice. If you have used Appendix D from this manual to submit your signature to Life Systems Software, your signature is embedded in your program. If you have not yet digitized your signature, print and complete the form in Appendix D, and mail it to Life Systems Software. Do NOT fax or email the form, since the signature will not appear correctly from fax or email copies. By selecting Digitized, when each CMS-1500 form prints, the provider’s signature is imprinted in box 31. If you make this selection and have not given us your signature, box 31 will contain only the printed name of the doctor but not the actual signature.
o NOTE: once the signature has been digitized, it will also be available for letters and reports created or edited in the SmartPad Template Editor.
•Name simply prints the provider’s name in box 31. Some insurance companies accept this while others do not. Be sure you know the rules of each company.
•Original requires that the provider actually signs each form.
•On File should be selected ONLY if and when the insurance carrier has notified you that it is keeping your signature on file and that it is not necessary to sign the form. This is extremely rare and unusual.