Signature-on-File Requirements
When a TRICARE beneficiary has signed a Release of Information statement,
you should indicate “signature on file” in Box 12 of the CMS-1500. A
new signature is required every year for professional claims submitted on
a CMS-1500 and for every admission for claims submitted on a UB-04.
If the beneficiary is under age 18, the parent or legal guardian should
sign the claim. However, a beneficiary under the age of 18 may sign the claim form
if the beneficiary is (or was) the spouse of an active duty service member (ADSM) or retiree, or if the services are
related to venereal disease, drug or alcohol abuse, or abortion
In situations when a
beneficiary is mentally incompetent or physically incapable, the
person signing should either be the legal guardian or, in the absence
of a legal guardian, a spouse or parent of the
beneficiary. See the Important Provider Information section of this
handbook
for more information
about the release of patient information.
If the beneficiary is
deceased, and you do not have a valid signature-on-file agreement, you
must submit one of the
following:
• A claim form signed by the legal
representative of the estate.
• Documentation accompanying the claim form
to show the person signing is the legally appointed
representative.
• If no legal representative has been
appointed, the parent, spouse, or next of kin may sign the claim form. The
signer must provide a statement that no legal representative has been appointed. The
statement should contain the date of the beneficiary’s death and the
signer’s relationship to the
beneficiary.
