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When a clinician with a supervisor signs a note, the supervisor co-signs it. This page is where an owner or manager decides what the supervisor attests to, how long a note may wait, who steps in when a supervisor is away, and whose notes always go to a supervisor.

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What counts and when

  • The deadline is counted in business days: your practice’s open days (the ones not marked closed in your business hours), in your practice’s time zone, from when the request is sent. The default is 3.
  • A change to the settings applies to requests sent after you save. A request already waiting keeps the deadline it was sent with.

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The statements supervisors attest to

Select Co-sign settings in the Co-sign inbox. Under Statements you see the common statements, for example “I have reviewed this note and agree with the assessment and plan.”
  • Edit changes the wording of one. A note co-signed earlier keeps the exact words that were attested to when it was signed.
  • Add a statement adds your own.
  • The switch beside a statement turns it off. At least one must stay on, because a supervisor cannot co-sign without choosing one.
  • Under By type of note choose which statement is already chosen for progress notes, group notes, psychotherapy notes, consultations and ward notes.
The supervisor chooses one when they co-sign and may add one sentence of their own. Both are printed under their name on the note and its PDF.

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Deadlines and reminders

Under Deadline set Business days to co-sign and Remind this many business days before. Switch on No deadline by default if you do not want one. Under By type of note you can switch No deadline on for a kind of note, or give it its own number of days.
  • One business day before the deadline the supervisor gets a reminder in the app and by e-mail.
  • When the deadline passes the request is marked Overdue in the Co-sign inbox, and the supervisor, you and your other owners and managers are told.
  • An owner or manager can move an overdue request to another of the author’s supervisors with Move to… in the Practice overview.
The e-mail says only how many notes are waiting, for example “You have 2 notes waiting for co-signature”. It never names a client. It follows each person’s notification settings and your practice’s e-mail switch.

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Cover while a supervisor is away

You can also name a cover when you add the absence: in the calendar’s Out of Office tab, choose a Covering co-signer (optional). It is the same setting as below, so you can change it later here. Select Cover while away. Each upcoming out-of-office block of a supervisor is listed. Choose a Covering co-signer for it. Owners and managers can set one for anyone, and can also choose a practice-wide default that applies while a supervisor is out and no one was named. While the supervisor is out, notes waiting for them go to the cover as well, including notes already waiting. Either can co-sign; whoever signs first closes the request, and the note records that it was co-signed while covering. The cover only sees clients they are already allowed to see. A note marked sensitive stays with the supervisor it was sent to and is never passed on.

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Notes that always need a co-signature

Select Who needs co-signing, then Change beside a person. Switch on Notes need co-signature and, if you wish, an end date (for example when they are licensed) and the kinds of note that are exempt. Every note they sign is then sent to their supervisor automatically. Anyone else can still ask for a co-signature by hand. If the person has no supervisor who can see the client, nothing is sent automatically and the author is told when they try to send it by hand.

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Which records can be co-signed

For a person whose notes need co-signature, the same step covers more than notes:
  • Treatment plans and each review of a plan. See Treatment Planners.
  • Interpretations of a scored measure such as the PHQ-9. See Scored measures.
  • Discharge summaries, both a ward discharge and a note written with the Discharge Summary template type.
They use the same inbox, deadlines, reminders and statements as a note. In Who needs co-signing, the exempt kinds now include Discharge summaries and Assessment interpretations, and each can have its own deadline and default statement under Deadlines and reminders.

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When a supervisor leaves

Notes waiting for them move to the practice-wide default cover when that person can see the client. If there is none, owners and managers are told to choose a new co-signer in the Practice overview. Their associates show No supervisor until you set a new one.

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A supervisor whose licence is missing or has lapsed

An expired licence on file stops a supervisor co-signing straight away. Co-sign stays off and the panel says why. The request stays waiting and an owner or manager can move it to another supervisor. A supervisor with no licence on file at all gets a grace period after this rule starts: they can still co-sign, and the panel shows Add your licence by and a date. After that date, a missing licence is refused the same way as an expired one. They add the licence in their own profile. Owners and managers see who is affected: open Co-sign settings and look for Supervisors without a current licence. It lists each supervisor (and the practice-wide covering co-signer) whose licence is missing or expired, with the date their grace ends.

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Turnaround report

Select Turnaround report, choose the dates, and read for each supervisor and associate how many requests there were, how many were co-signed, the average time to co-sign, how many are overdue now, and the share that came back with changes requested. Export CSV downloads it. The report names no client.

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US claims

On US claims, a note’s supervisor is sent as the supervising provider beside the clinician. See Insurance claims.

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Who can do this