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Published 10/27/2023. Medicare requires the signature of the beneficiary, or that of his or her representative, for each date of transport, for both the purpose of accepting assignment and submitting a claim to Medicare.
Definition of signature on file This form of cardholder identification is used most often by mail order merchants, and by hotel chains when billing additional charges after a hotel guest has checked out. If the customer disputes a charge, he or she signs an affidavit.
The patients signature or the statement signature on file in this item authorizes payment of medical benefits to the physician or supplier. The patient or his/her authorized representative signs this item or the signature must be on file separately with the provider as an authorization.
Box 12 is the release of information box. Many billers think that if you dont have to release any information, you can just leave this blank. Others think you just stick signature on file there and youre good.
If there is no signature on file, leave blank or enter No Signature on File. DESCRIPTION: The Patients or Authorized Persons 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.

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Statement to Permit Payment of Any Health Insurance. Benefits to Supplier, Physician, or Patient.

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