23 MAC Pt. 200, R. 1.11
Provider Claim Submission Signatures
Cite as 23 Miss. Admin. Code Pt. 200, R. 1.11
Provider Claim Submission Signatures
A. The Division of Medicaid allows providers’ signatures on claims to be applied using one (1)
of four (4) different methods:
1. Electronic signature [Refer to Miss. Admin. Code Part 200, Rule 1.10],
2. Typed signature,
3. Signature stamp bearing the signature of the provider, or
4. Handwritten only by the provider. The ability to make a handwritten signature may not
be delegated to another party.
B. A provider may delegate the ability to affix their electronic, typed, or stamped signature to an
authorized provider representative when submitting claims on the provider’s behalf. The
provider must complete and keep on file the Appointment of Authorized Provider
Representative or Agent Form included in the Mississippi Medicaid Provider Billing
Handbook. [Refer to Miss. Admin. Code part 200, Rule 1.9.]
C. If there is no printed name accompanying an electronic, typed, or signature stamp, it is
presumed that the provider affixed the signature to the claim.