Confidentiality, Privacy and Security

Voice Signatures

  • 1.  Voice Signatures

    Posted 10-29-2019 11:02

    I received a request for PHI from an insurance company and the authorization form had "voice signed by xx" on the signature line.  What are the regulations for voice signatures?  Does anyone have any resources on the issue?

    Ta-Tanisha Ingram, MSM, RHIA, CHPS
    Medical Records Administrator/District Privacy Officer

  • 2.  RE: Voice Signatures

    Posted 12-02-2019 12:58

    I do not have any resources on the issue, however, I would be very uncomfortable with accepting a verbal signature. For the most part, we do not even accept electronic signatures unless we know how the patient's identity was confirmed (i.e. unique login, last 4 digits of social, etc.). In this situation I would just deny this request and tell the requester that you cannot accept a verbal signature and the authorization must be physically signed by the patient.

    Our motto here is "When in doubt, don't give it out".

    Lauren Reyes
    Manager, Health Information Management - Carris
    CentraCare Health

  • 3.  RE: Voice Signatures

    Posted 12-03-2019 05:50
    The easiest way to answer this is that ANY signature must be verifiable, which is the point of a signature.  I have never heard of a voice signature, even going through all of my recent studies through my cyber security degree program.  And I am unsure how one would even be able to ever verify a voice signature.  With electronic signatures, they are only verifiable as a "digital signature" meaning they have printed name, date and time stamp included and could always be verified by checking logs.  And as far as I know, there are no regulations pertaining to "voice signatures", so I would just adopt the standard practice of not accepting them and require digital (electronic) or hand signatures.

    Dustin Clapp, RHIT
    HIM Specialist
    Richmond, VA

  • 4.  RE: Voice Signatures

    Posted 12-04-2019 11:01

    We've seen a few instances of voice signatures as well. There is a federal law for accepting electronic signatures in commerce that can provide some guidance. The laws begin at 15 USC 7001 and the definitions statute is at 15 USC 7006:
    (5) Electronic signature

    The term "electronic signature" means an electronic sound, symbol, or process, attached to or logically associated with a contract or other record and executed or adopted by a person with the intent to sign the record.

    Most states have similar laws defining electronic signatures you might check as well, which could either similarly include electronic sounds or exclude electronic sounds from the definition of a valid electronic signatures. Many of these do not require an organization accept an electronic signature, but the federal law for example requires certain government agencies to accept any otherwise valid electronic signature. We are considering ways to confirm the validity and identity of a voice signature similar to processes to confirm the validity of a handwritten or other electronic signature, where I anticipate we'll see more of these as the technology develops and becomes more widely available.

    Richelle Marting
    Attorney/Clinical Adjunct Facult

  • 5.  RE: Voice Signatures

    Posted 12-05-2019 08:02
    I've not seen that yet. Any time I question a signature, we call the patient and get verbal authorization. It never hurts to double check.

    DeAnn Tucker
    HIM Director & Privacy Officer
    Houston Physicians' Hospital