Sign-off is a review screen, and it is honest about that: Review workspace. Nothing here is final or transmitted. Finalize controls unlock only after the required review confirmations below are checked.
What is in front of you
Visit close-out review, with the patient, visit type, duration, transcript segment count and confirmed draft order count along the top.
Then, in order: the note, the final SOAP note, the differential, the suggested orders, the draft coding, referral, and the prior-authorization checklist.
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The note card is titled The note (write it, or have the AI write it) while unsigned — this is where ✦ Write note with AI lives.
The Final note · SOAP card shows what will actually be stored: Stored on sign-off (read-only once signed) and transmitted to other clinicians as a SOAP note.
The five confirmations
Required review confirmations — all five, verbatim:
- I reviewed and edited the draft note.
- I reviewed the differential (clinician-review-only).
- I reviewed every draft order; none are auto-transmitted.
- I reviewed the suggested coding and attest to the codes I accept.
- I am the licensed clinician of record for this encounter.
Screenshot pending capture
Finalizing
Sign & finalize visit (auto-bill 837P) is disabled until all five are ticked. Afterwards it reads Visit finalized + billed.
If nothing is attested you get a blocking message: Please attest at least one code (check the boxes in Draft coding) before finalizing.
Sign-off then:
- stores the note, read-only
- captures charges from your attested codes and generates the 837P claim
- moves the appointment to Ready for checkout — reason Visit signed off — ready for checkout — which is what puts the patient in the front desk's queue
The billing card afterwards shows ✓ Billed & submitted with the claim number, status, total, and a View 837P EDI preview expander.
What locks
The note card becomes Note — signed & locked:
This note is signed and locked (read-only). Review the final note below; you can print or export a copy. An administrator can reopen it for correction.
A strip appears: ✓ Signed note stored (#abc12345) — read-only (locked). View, print, or export a copy. with Print and Export .txt — and, for administrators only, Unlock (admin).
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A non-administrator pressing unlock gets Only an administrator can unlock a signed note. When an admin does unlock it, the note returns to draft on the same row and must be re-signed; the prior signed version is retained.
Correcting a signed note
The console has no addendum control — corrections happen in the patient's chart, in the notes panel, where a signed note offers Amend and + Addendum.
- + Addendum asks for text and appends it as ↳ addendum: …
- Amend opens Amend signed note (creates a new version; original retained) and requires Reason for amendment (required) — e.g. corrected medication dose. You get Note amended — the original version is retained.
- History shows Revision history (all versions retained), every version with its change type, reason and timestamp
Nothing is ever overwritten. A note carries AMENDED ×2 and its full history, which is what you want when somebody asks two years later what you knew and when.
What usually goes wrong
Ticking the five without reading them. They are attestations. If you did not review the orders, do not tick the box that says you did.
Signing before the note is right. Amending afterwards is possible and permanent — the original version is retained forever, along with your reason.
Forgetting the visit moves. Sign-off pushes the patient to the checkout queue. If you sign early, the desk will try to check out a patient still in the room.
Assuming an addendum replaces the note. It appends. The original text stays exactly as signed.