Why these chartsrules and progress
By supervising physiciansplit and terms
Dr. Abraham is the delegating physician for all mid-levels per the filed protocol agreements. The PA's board record is being confirmed.
Audit packet
Everything a board reviewer or Medicare auditor would ask for, in one file.
Charts
Charts needing attention are at the top. Tap a chart to see what was found, or use Start reviewing to go through them one at a time. Flagged charts are with the PA or NP first, suggested fix attached; Dr. Abraham sees every chart and its status here, and signs what returns re-checked.
Audit trail
A permanent record of every import, selection, finding, and signature. Tap an entry to open its chart.
Users and roles
Everyone sees only what their role needs. Physicians see their assigned providers' charts; PAs and NPs see their own; billing sees incident-to flags only.
Writing samples teach Cosigna each physician's voice, so send-back notes read like they wrote them. Samples are private to each user and never shared between users. Every draft is reviewed and sent by the physician, and the audit trail records it as drafted with Cosigna, sent by them.
Practice settings
Everything Cosigna enforces and how it looks, editable by your administrator, no technical knowledge needed. Changes apply to future cycles; past cycles keep the version in force, so your audit trail stays honest.
Enforcement rulesper provider
Aetna: SA modifier required on NP incident-to claims since 4/1/2025. BCBS of Georgia: follows Medicare incident-to conditions. Payer rules are enforced at the same gate as Medicare's.
Audit criteria in force
Data imports
How charts get into Cosigna: a read-only weekly sync from your EHR, and a one-time historical backfill so cross-visit checks and open loops see the whole story.
Automated: EHR connections
Connect once. Cosigna pulls progress notes read-only every Friday and backfills twelve months overnight. You approve access inside your own EHR; Cosigna never sees a password.
Import history
Manual: bring a spreadsheetCSV from any system
Export encounters from your old system as a spreadsheet. Columns: encounter_id, date_of_service, provider, cpt, dx, note_excerpt, open_loop. Cosigna validates every row before anything is indexed.
Recovery intake: payer reports and notes
One drop for everything; Cosigna reads each file and routes it. Progress notes (PDF) go to pre-check on upload. Payer reports (835 remittance files straight from eClinicalWorks or the clearinghouse, or ERA/EOB spreadsheets) rebuild the Denials and recovery lane for everyone, identifiers dropped at upload: only payer, service month, code, amount, reason, and the payment date are kept. PDF remittances queue for the live parser; chart lists land on the intake log.
Practice health
Everything Georgia and Medicare expect from a supervising practice, in one place, with receipts.
Compliance calendar
Controlled substances
Incident-to gate
Problem lists
AWV finder
Outreach
Unsigned note aging
Charts waiting on a physician signature, by age.
Open loops
Things a note promised that never happened. These are the misses that become lawsuits.
Denials & recovery
Billing integrity
Claims held before submission because the note doesn't support the code.
E/M mix this quarter: 99214+99215 are 61% of established visits against a 48% peer average, inside Palmetto GBA's standing TPE screen for JJ. Modifier 25 sits at 9% versus 11% peer: clean. One cloned note is held below.
Credentials & scope
Audit response packet
If a request lands, Cosigna assembles the evidence in minutes: notes, supervision reviews, criteria versions in force, signatures, corrections.