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Forwarding & Cosigning Notes

Let's review how to forward SOAP notes in 1.0 documentation. One key thing to remember is that the location where the note started needs to be the same location where the therapist is logged into when they go to finalize it. If the therapist is in a different clinic location than where the note was forwarded from, the note will not appear in the Incomplete Cosign Docs at a glance alert.


First, you’ll need to make sure that the user has the Forward SOAP Notes permission.

How to Forward a SOAP Note

Before you forward a SOAP note, ensure that:

  • The documentation is complete (free of errors)
  • The documentation is accurate (no over or underbilling)

The system will generate an error when you try to forward a note if discrepancies are detected.

  1. Navigate to the “Plan” tab for Daily Notes or the “Billing” tab for evaluative notes.
  2. Select the desired therapist from the drop-down list at the bottom of the page. Notes can only be forwarded to a PT-type user (PT, OT, or SLP).
  3. Click the corresponding “Forward Daily Note to” or “Forward Progress Note to” button.

How to Sign a Forwarded SOAP Note

A therapist will know when they have a note the forwarded note to cosign when the “Incomplete Cosign Docs” alert appears in their At A Glance section. Remember, the therapist must be logged into the location where the assistant started the documentation. The document will not appear on the list if the therapist is logged into a different clinic. 

  1. Clicking this alert will bring you to the Incomplete Cosign Documents page. Navigating to the note through any other method will result in a single signature on the document, not a co-signature. If the therapist opens the draft note incorrectly, save it as a draft. The assistant should then open an Addendum on the draft note and forward it to the therapist again.
  2. Select the desired note from the list. 
  3. Review the SOAP note. If any changes are needed, inform the documenting therapist to make the corrections and re-forward the note.
  4. Complete MIPS Measures, as appropriate. Because assistant user types are not eligible to participate in MIPS, MIPS measure fields do not appear on the note when the assistant is documenting. When the assistant forwards the note to a Supervising Therapist that is required to document MIPS, the MIPS Measure fields become available. The Supervising Therapist must complete the eligible measures or select the options indicating failure to meet the measures to finalize the note. 
  5. Navigate to the “Plan” tab for Daily Notes or the “Billing” tab for evaluative notes.
  6. Select “Finalize Daily Note” or “Finalize Progress Note” at the bottom of the page. Both signatures will then be listed on the note.

On the patient’s chart, the documenting therapist’s initials will appear in parentheses next to the finalizing therapist’s initials.

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