An electronic signature is considered to be a valid signature provided that all requirements for its use are met.


Requirements for an electronic signature:

(1) The electronic signature must be secure, with adequate protection. Protection is usually is in the form of a private password with or without use of biometrics, smart card or other device. The computer system should be able to provide adequate proof that the system is secure.

(2) There must be a policy outlining the official use of an electronic signature and the provisions taken to ensure that no one else can use it.

(3) There must be enforcement to ensure that only that intended person uses the electronic signature.

(4) Once signed the material is protected from modification. Any change results in a supplemental, revised or corrected report.


A facsimile (fax) of the electronic signature is considered adequate for CMS documentation..


The main prohibition in the use of the electronic signature is that the provider must not give the password to anyone else. This would mean someone else other than the intended person could sign documentation.


Acceptable wording in the electronic signature prior to the patient's name:

(1) approved by

(2) authenticated by

(3) completed by

(4) electronically signed by

(5) finalized by

(6) validated by


Some electronic signatures provide a digital image of the person's signature. This is not required for an electronic signature. The key element of the electronic signature is that only the intended person can use it, making it equivalent to a real signature.


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