Note Co-Signing

Purpose

Review set up and function of note co-signing. 

Audience

Practice administrators and clinicians.

Overview

Within DocNow providers have the ability to have notes co-signed. When users with specific credentials like NP or PA are associated with other providers who are MDs or DOs they can request to have their notes co-signed. 

Table of Contents

Admin Set Up
Provider Workflow
Considerations

Admin Set Up 

1. Ensure that the Co-sign user permission has been assigned to who need to have their notes co-signed.

2. Additionally the co-signing provider must also be associated under the Provider-Provider associations tab, found within the Associations tab of the Admin Portal. 
   
   
    
3. Both providers must also be associated to the same facility under the Provider-Facility associations tab, found within the Associations tab of the Admin Portal. 
   
   
    

Co-signer Upload Behavior

Company Admins can now adjust the upload behavior of Co-signed progress notes. Previously notes were only uploaded to integrated facilities (i.e. PointClickCare, MatrixCare) upon both the author and co-signer signing the note. A company setting now exists for changing the default behavior.

Admin Portal

Adjust the Co-signing settings by navigating to Admin Portal>>Welcome Banner>>Settings>>Co-sign Settings

Two options exist which are applied to all users with the Co-signer permission enabled:

Option 1: Upload after Co-sign 

The note is signed and uploaded only after the co-signer completes the co-signature. This functionality has always been the default behavior in DocNow.

Option 2: Upload at time of initial signature (New functionality)

The note is signed and uploaded immediately when the author signs it (with a co-signer selected), allowing the co-signer to only create an addendum and sign it. When the co-signer opens the note, "Create Addendum" button becomes available.

 

Provider Workflow 

1. When a provider who needs their note to be co-signed is finished with a note they will choose the option to Co-Sign by selecting a check box near their Sign button.
2. After choosing Co-Sign they will choose their co-signing provider from a drop down. After choosing the provider they will select Sign to finish their note. 

Note: A user with the Co-sign permission enabled is not required to select a co-signer prior to signing a note (e.g. Notes can be signed without clicking the Co-signer checkbox)


 

3. After they have finalized their note for co-signing, the icon for the note will change to two red checks which means they can no longer edit the note. Now the co-signing provider must finish this note. 

   Note: The note is not considered signed and will not be uploaded at this point. The co-signing provider must finish the process for the note to be signed and uploaded. 
   
   
    

4. The co-signer will access the note through their dashboard under the Co-Signed tab of their My Documents section. Viewing the note from here will open the note for them to review and sign. 
   
   
    
5. The co-signer can make edits to the note content, and then when they are ready they select the Sign button. Once the co-signer signs the note it is finalized and if applicable uploaded (for notes under a PCC or MatrixCare facility). 
   
   
    
6. Either provider can submit the corresponding charge information. The originating author's NPI will be the primary NPI associated with the charge information unless Split Billing is enabled. 

Considerations 

• The originating note author can view any notes they have submitted for co-signing in the Unsigned section of My Documents tab within their provider Dashboard. Once the co-signer has finished the note it will appear under the Uploaded section unless there was a problem uploading. 
  
  
• Any user title/credential that is not MD or DO should be able to originate and request notes to be cosigned.