Cosign Policy Setup

Clinicient Insight allows you to set up automatic routing of documentation to a supervising therapist on a patient's Case. The system should be set up to enforce your policy for cosigning documentation for certified and licensed assistants. Note that your policy must take into account all pertinent regulations and payer policies, including:

  • CMS and HIPAA regulations
  • State and local regulations
  • All other payer policies and contracts

Cosigning is not necessarily allowed for non-credentialed or non-licensed therapists. If you have any questions about instituting a co-signature policy for your clinical documentation, you should hire a knowledgeable consultant or healthcare attorney for advice.

The following topics describe the Co-signature Setup:

Cosign Global Settings

The cosign feature allows management to decide whether or not all daily chart notes are signed off by the supervising therapist.

Note: It is your responsibility to take into account all pertinent regulations and payer requirements to determine whether or not the supervising therapist must cosign all documentation or just evaluations.

If you select the Require cosign for all documentation by non-supervising therapist check box, all daily documentation will be routed to the supervising therapist for review and cosignature. Otherwise, only evaluation and re-evaluation documentation will be routed to the supervising therapist for review and cosignature.

Important Note: In either instance, the supervising therapist's credentials will be listed as the rendering provider on all claims if you do not select the May treat without supervisor cosign in the Add/Edit Staff dialog for the treating clinician.

Clinical Supervisor Settings

Clinicians must be classified as to whether or not they are allowed to treat patients without supervision in the Add/Edit Staff dialog. This has important implications for claim processing and cosigning clinical documentation.

For most licensed therapists, you should check the May treat without supervisor cosign check box. If you choose not to select this check box, all claims for the selected clinician will list the supervising therapist as the rendering provider. It is your responsibility to take all legal and payer requirements into consideration if you choose not to select this check box .

Note: Most payers require claims to be billed under the rendering provider (treating therapist). The cosign feature is designed for assistants and generally should not be used to enable one licensed therapist to cosign another licensed therapists documentation.

Rendering Provider ID

The Payer Setup in Clinicient Insight impacts what is included in a CMS-1500 claim, based on the following settings on the CMS-1500 tab of the Edit Payers dialog:

  • Rendering Provider ID under NPI: Setting this field to Caregiver NPI causes the treating caregiver's NPI to be reported.
  • Rendering Provider ID under Legacy ID: Setting this field to Caregiver Provider # or Caregiver State License causes the treating caregivers number to be reported.
  • Tax ID: Setting this field to Caregiver SSN or Caregiver-Payer Provider Number causes the treating caregiver's number to be reported.

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