Box 31 - Signature of Physician or Supplier

 

Box31's primary purpose is to place the Full Name and Credentials of the provider of service for the sessions shown in Box24 of the HCFA-1500.  In addition, DELPHI32 will place the State Registration/License # or any other selectable code below the full name and credentials.  Lastly, DELPHI32 will print the date that the claim was created in the lower right section of Box 31.

 

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