Patient signatures in clinic

Some signatures come from the patient or a caregiver rather than a provider. They sign on a clinic tablet or computer: they type their full name, say who they are (the patient, a parent, a legal guardian, a caregiver or another representative) and then sign in one of two ways.

• Type (the default): their name appears in a handwritten signature style. This works with a keyboard alone, so it suits anyone who cannot draw on the screen.
• Draw: they sign in the box with a finger, a stylus or the mouse. Clear starts over.

Switch between Type and Draw by clicking the tabs, or with the arrow keys. NeatPractice keeps with each signature how it was made, the name as typed, who signed, the time the server received it, the staff member whose device it was, and the device's network address and browser. These details stay in your clinic's records as proof of service.

Under a patient's or caregiver's signature, the visit and the document show a line such as Signed on iPad, Safari; hover over it to see the full browser details. The network address is a personal identifier, so only users who can read the audit log see it on screen (Signed on iPad, Safari from 203.0.113.7). The signed copy of a document prints the device and address in the small evidence line under each signature. Signatures collected before NeatPractice kept these details show no device line.

Visit attestation#

An attestation is the patient's or caregiver's signature that the services of a visit were received.

• Turn on Collect patient attestations in Patient settings to offer it on every visit.
• A payer can require it: turn on Patient attestation required in the payer's billing rules. On a visit with that payer, the attestation is listed under Before signing, and the visit cannot be signed until the patient or caregiver signs.

To collect it:

1. Open the visit and find Patient attestation.
2. Click Collect Signature and hand over the device.
3. The patient or caregiver types their full name, chooses who they are, keeps the typed signature or draws one, checks I agree with the statement above and adopt this as my electronic signature and clicks Sign.

A code can also ask for it, as can the payer for that code (see Code rules). In some disciplines, such as ABA, the caregiver signs only once the session has ended; collecting it earlier is refused.

Each visit takes one attestation, and it cannot be changed. The visit list shows a mark in the Patient signed column.

To see it, click View Signed Attestation in Patient attestation. The whole record opens as a PDF: the visit's date, time, provider and services, the statement exactly as signed, who signed and their relationship, the time, how it was signed, the device and the signature. Click Download to save it or Print to print it.

When the visit changes after signing#

The patient or caregiver signed for a specific session. If any of these change afterward, NeatPractice clears the signature:

• the date of service
• the start or end time
• the place of service
• the treatment codes or their units (adding, removing or swapping a code, or a change in units)

Other edits keep it: diagnoses, modifiers, diagnosis pointers, the order of the lines, or minutes that do not change the units. This applies to edits of a draft visit and to billing corrections made through an addendum.

The cleared signature is never deleted; it stays in the visit's history for audit. The Patient attestation section shows Signature cleared with what changed, the visit goes back to needing the signature (a payer that requires it lists it under Before signing again) and you collect it again with Collect Signature.

On a visit the provider already signed, collecting the attestation again needs the Visits: Recapture Attestation permission. Clinic Admins and Clinical Supervisors have it.

Recapture a signature#

Sometimes the signature itself is the problem: the wrong person signed, it cannot be read, or it was given for the wrong session. While the visit is not signed yet, a user with Visits: Recapture Attestation can click Recapture Signature in Patient attestation, enter the reason and click Clear Signature. The signature is cleared but kept in the visit's history with who cleared it, when and why; the section shows the reason, and you collect it again with Collect Signature. Once the provider signs the visit, its attestation can no longer be recaptured.

Patient forms#

Patient forms, such as the stock intake questionnaire, are filled in and signed by the patient or a caregiver in clinic.

1. On the patient's Documentation tab, click New Document and choose a Patient form template.
2. Hand over the device. The patient or caregiver answers the questions; NeatPractice saves as they type.
3. Click Sign in Clinic. They type their name, choose who they are, type or draw their signature, check the statement and click Sign.

The signed form is locked like any signed document, with a signed copy you can print or send. The signed copy shows a typed signature in the signature style, or the drawn one, with a small line naming who signed, how and when (in UTC). A provider cannot sign a patient form in the patient's place.

Clinics build their own patient forms in Templates with the Patient form document type.

Permissions#