Cosign Clinical Documentation

The following describes how to route documentation completed by an assistant to be reviewed and electronically cosigned by a supervising therapist.

Cosigning Setup

Insight EMR must be set up properly to use cosigning of clinical documentation. For more information on how to set up cosigning, see Set Up Documentation Cosigning.

Setting up the Therapist

Use the following steps to set up the supervising therapist:

  1. From the Edit menu, select Staff to open the Add/Edit Staff dialog box.
  2. In the Name list, select the name of the therapist to enable as a supervising therapist.
  3. In the Name area of the dialog select the May treat without supervisor cosign check box.

  1. Click Save to update the staff record.
  2. Click Close to close the Add/Edit dialog.

Setting up the Assistant

Use the following steps to set the assistant.

  1. From the Edit menu, select Staff to open the Add/Edit Staff dialog box.
  2. In the Name list, select the name of the assistant.
  3. In the Name area of the dialog, ensure that the May treat without supervisor cosign check box is not selected.
  4. Click Save to update the staff record.
  5. Click Close to close the Add/Edit dialog.

Entering the Patient's Case

When entering the case information for a patient, a supervising therapist will be assigned to the case. Generally, the supervising therapist for the case will be the therapist performing the initial evaluation.

Follow these steps to properly set up the patient's case:

  1. To open the Client Editor, click the Client icon or press F9.
  2. Click the Name arrow to select the desired patient.
  3. Select the Case Information tab or press F4.
  4. In the Cases area of the dialog, select the appropriate patient case.
  5. Click the Supervisor arrow and select the supervising therapist from the list.

  1. Click Save.
  2. Click OK to close the Client Editor dialog.

Signing Off by the Assistant

When signing the clinical documentation for a visit, the assistant (non-supervising therapist) is prompted to route the documentation to a supervising therapist. The supervising therapist must be:

  • Able to treat patient without supervision
  • Credentialed with the patient's payer
  • Able to view the schedule for the clinic where the visit occurred

The assistant uses the following steps to route charting documentation to a supervising therapist during the sign off process:

  1. In the Chart tab, click the Sign icon. The Sign Chart Note dialog appears with the supervising therapist displaying in the Routing field by default.
  2. To select a different supervising therapist, click the Supervisor arrow and select one from the list.

  1. To complete the visit sign off, click Sign Off. The documentation is routed to the supervising therapist and appears on the charting schedule with a red flag.

Review and Sign Off by the Supervising Therapist

To complete the sign off process, the supervising therapist reviews the documentation completed by the assistant and then signs off on it themselves. Use the following steps to review and complete the documentation sign off by the supervising therapist:

  1. In the Chart tab, click the Unsigned subtab to display a list of the unsigned documentation. The visit requiring co-signature automatically appears on the unsigned documentation list of the cosigning therapist for the visit. Hover over the visit in the unsigned list to show the date and name of the non-supervising therapist who routed the documentation for a co-signature.

  1. To open the documentation for review and revision as needed, click the desired visit.
  2. To open the Sign Chart Notes dialog for adding your electronic cosignature to the documentation, click Sign.
  3. To electronically sign the documentation, enter your password in the Password field. The documentation will include a signature line and both date and time stamp for both therapists.

Charge and Claim Processing

If your clinic uses Insight Billing to manage charges, the charges display the names of both the non-supervising or assistant therapist as well as the cosigning supervising therapist.

Assistant Sign Off (PTA, OTA)

For Evaluation Visits

For payers that do not require credentialing, the assistant will be required to route documentation to supervising therapist (as identified on case) for sign off. The co-signing therapist will be the supervising therapist on the claim.

For payers that do require credentialing, the assistant will be required to route documentation to a credentialed therapist (available in drop down) for sign off. The co-signing therapist will be the supervising therapist on the claim.

For Standard Visits

For payers that do not require credentialing, the assistant can select a supervisor in the drop down, and if the route to supervisor for signing check box is selected, the documentation will be routed to the supervisor for co-signature. If no supervisor is selected in the drop down, the supervising therapist on the case will show as the supervising therapist on the claim.

For payers that do require credentialing, the assistant can select from a list of credentialed therapists in the drop down, and if the route to supervisor for signing check box is checked, the documentation will be routed to the supervisor for co-signature. If no supervisor is selected in the drop down, the supervising therapist on the case will show as the supervising therapist on the claim.

How Different Cosign Settings Interact

To see if a cosigner will be required based on the settings applied to your account, play the interactive video below.

Cosign Settings in INSIGHT

An interactive guide that will show you the result of combining different cosign settings in INSIGHT.

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