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December 31, 2015 - Reviewed: 04.07.2022

Important Information Regarding Attestations

CGS is seeing a significant increase in denials due to no response to our attestation requests. As outlined in the CMS Publication 100-08 Program Integrity Manual, Chapter 3 Verifying Potential Errors and Taking Corrective Actions, sec Signature Requirements, providers have 20 days to respond to a request for an attestation due to a missing/illegible signature on medical records.

Important Facts:

  • The MACs, CERT and UPIC shall NOT contact the biller when the claim should be denied for reasons unrelated to the signature requirement.
    • In other words, if we contact you for an attestation your services are allowable and will only be denied if the completed attestation is not returned.
  • Reviewers shall NOT consider attestation statements from someone other than the author of the medical record entry in question (even in cases where two individuals are in the same group, one should not sign for the other in medical record entries or attestation statements)
    • Attestations CANNOT be completed by an office manager, billing service or any other person other than the author of the record.
  • CMS would permit use of a rubber stamp for signature in accordance with the Rehabilitation Act of 1973 in the case of an author with a physical disability that can provide proof to a CMS contractor of his/her inability to sign their signature due to their disability. By affixing the rubber stamp, the provider is certifying that they have reviewed the document.
    • All other stamps are NOT acceptable.

CGS Process:

  • CGS will fax a request for the attestation which includes your patient's first initial, last name, and the Date of Service.
    • We do not want to release any PHI, so full names and Dates of Birth are not included. Please call the number listed at the bottom of the request for details.
  • The fax number being used is the number listed in PECOs.
    • If you receive a request that is not your provider, to assist your fellow providers please fax back to the number listed on the cover sheet and let us know so we can locate the correct provider.
  • To better serve you, CGS attempts to send out reminders approximately one week prior to the due date.


  • The attestation process can delay your payment up to 84 days.
  • Signature denials require an appeal, which can delay payment even longer.

Question/concerns can be directed to our Customer Service area:

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