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Forward/Cosign Note Workflow

Review how to forward a SOAP note to have it finalized by a therapist and the process for signing a forwarded note as the supervising therapist.

Note: Forwarding a SOAP note in 2.0 is similar to the 1.0 process.

Important: You cannot forward a note once it has been finalized by adding an addendum.


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 (you haven’t under or overbilled).

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

  1. Use the (...) button at the top of the note to select Forward.
  2. Select the supervising therapist from the drop-down, then click Apply. Notes can only be forwarded to a provider user type (PT, OT, SLP).

How to Sign a Forwarded SOAP Note

Notes requiring a co-signature will appear in the therapist's  At a Glance view under the Incomplete Cosign Docs section.

Important: Follow the steps below to access the cosign document. Opening the note using any other method will result in a single signature on the document, not a co-signature. If the therapist opens the 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.

  1. Click on the Incomplete Cosign Docs alert to open a table of all pending cosign notes.
  2. From the Incomplete Cosign Documents table, select the note needing to be co-signed.
  3. Review the SOAP note. If any changes are needed, inform the documenting therapist to make the corrections and re-forward the note.
    1. MIPS Reporting: 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. 
  4. Click Sign at the top of the note.
  5. Both the assistant and finalizing therapists’ information will appear on the finalized note.
  6. The patient’s chart will reflect the supervising therapist’s name.
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