New York State Seal
STATE OF NEW YORK
INSURANCE DEPARTMENT
25 BEAVER STREET
NEW YORK, NEW YORK 10004

The Office of General Counsel issued the following informal opinion on December 24, 2001, representing the position of the New York State Insurance Department.

Re: Requirement of Patient’s Original Signature on HCFA Forms

Questions Presented:

Is the Health Care Financing Administration ("HCFA-1500") insurance claim form, that is occasionally utilized by treating physicians when billing insurers for No-Fault benefits for health services rendered, prescribed by or regulated by the Department?

May an insurer require that a patient’s original signature be provided on theHCFA billing form, instead of a "signature on file" stamp?

Conclusions:

No. The HCFA-1500 form is not a prescribed No-Fault form that is subject to approval by the Department, thus the contents and requirements therein are not regulated by the Department.

Yes. When deemed necessary for verification purposes, an insurer may require that the physician submit a HCFA-1500 form with the patient’s actual signature in order to establish proof of claim.

Facts:

The question is general in nature.

Analysis:

The billing form submitted appears to be the Health Care Financing Administration (HCFA-1500) form that is prescribed and approved by the American Medical Association Council on Medical Service. As such, whether a patient’s original signature is or is not required on the HCFA form is a matter to be resolved by agreement between the patient and physician. A form that the Department prescribes, which may be used at the option of treating physicians when billing insurers, is designated as the NF-3 form. The NF-3 form that is currently in effect does not require a patient’s signature.

Please note, however, that regardless of what form a treating physician utilizes when billing insurers, when deemed necessary to prevent fraud or for verification purposes, an insurer may require that a patient’s original signature be provided prior to disbursing payments.

For further information you may contact Senior Attorney D. Monica Marsh at the New York City Office.