Sign and submit your session note
Last updated: July 28, 2026
Once Alpaca has finished processing your session and you've reviewed the note, the last step is to sign it. Signing is what sends your note into billing and payroll, so this is the most important click you'll make on a note. This article walks through the happy path — review, sign, done — and then explains the common reasons a sign-off gets blocked and how to fix each one.
If your note is stuck processing, has the wrong time, or landed on the wrong client, see the companion article “Session Notes: Lifecycle and Troubleshooting” instead. This article assumes your note is generated and ready to sign.
What signing actually does
Signing a session note is a legal attestation, and it does three things at once:
It locks the note. A signed note can't be freely edited — changing it later invalidates the signature and the note has to be re-signed.
It feeds billing. The signed note becomes a claim. The CPT code, units, place of service, and any modifier you set are exactly what gets sent to insurance, so they need to be right before you sign.
It feeds payroll. The date you sign determines which pay period the session falls into. Signing promptly keeps your hours in the right period.
Signing also captures your signature, along with the time, location, and device details, as part of the compliance record. There isn't a separate “submit” button for you to press afterward — finalizing and signing the note is what submits it into billing and payroll.
How to sign and submit
1. Open the sign-off screen
From a completed note, click Sign off. This opens the Sign Session Note panel, where you'll confirm the session details and add your signature.
2. Check the date, time, and units
Alpaca pre-fills the start and end time from the appointment or your recording. Review the Start and End fields and correct them if they don't match the actual session. The Units total is calculated automatically from the duration (using the standard 8-minute rounding rule), so it updates as you adjust the time.
When the time is right, click Verify Time. You'll see a confirmation that the start and end time are verified. You can't finalize until the time is verified, so don't skip this step.
3. Confirm the billing details
Make sure the Place of Service and CPT code are set (and a modifier, if your session needs one). These usually come pre-filled, but they must be present to finalize.
4. Add your signature
Draw your signature in the Clinician Signature box. A Patient Signature box is also available but is optional. If this is a Medicaid / EVV session, you'll see a note that your location will be included with your signature — allow location access when your browser asks (more on this below).
5. Finalize
As you complete each step, a Requirements to finalize checklist shows what's still outstanding: place of service selected, CPT code selected, time verified, and clinician signature drawn. When everything is checked off, the finalize button becomes active.
Click the finalize button (labeled Finalize Session Note Now at the top of the panel, or Finalize and Sign Session Note at the bottom). A Confirm Signing of Session Note dialog appears with a short review countdown. Read it, tick the I confirm checkbox to attest that the note contains only billable session time (no drive time, admin time, or other non-billable activity), then click Confirm & Sign.
You'll see “Session note signed successfully” and the panel closes. Your note is now signed and on its way to billing and payroll.
Not ready to sign yet?
If you want to save your progress (for example to capture a parent signature now and finish later) without finalizing, click Save and Finish Note Later. This keeps your work without locking the note or sending it to billing.
Why a sign-off gets blocked — and how to fix it
Alpaca deliberately checks a lot before it lets you sign, because catching a problem now is far easier than fixing a denied claim or a payroll correction later. Here are the most common blocks and their fixes.
A required field is missing
If the finalize button stays disabled, check the Requirements to finalize checklist — anything without a green check is what's holding you up. The usual culprits and their fixes:
What's missing | How to fix it |
|---|---|
Place of service not selected | Pick the correct place of service. |
CPT code not selected | Pick the correct CPT code (and modifier, if needed). |
Time not verified | Confirm the Start/End time and click Verify Time. |
Clinician signature not drawn | Draw your signature in the Clinician Signature box. |
If you try to finalize before the time is verified, you'll be prompted to click Verify Time first. If you enter a time that doesn't make sense (for example an end before the start), fix the time error before you can verify.
A compliance or verification check failed
The sign-off screen runs Alpaca's validations against your note and shows any problems in two groups:
Must resolve — blocking issues. You can't finalize until these are cleared.
Heads up — warnings worth a look, but they won't stop you from signing.
Open any item to see the suggested next steps, then make the correction (for example fixing the CPT code, units, or place of service) and the check will re-run. If a “Must resolve” item isn't clear or you can't work out how to clear it, reach out to support at support@alpacahealth.io.
Location is required (Medicaid / EVV sessions)
For Medicaid sessions, Electronic Visit Verification (EVV) requires your location at sign time to prove you were present. If your browser blocks location, you'll see a message like “Unable to get location. Please enable location permissions and try again.” and signing will be blocked.
To fix it, enable location permissions for Alpaca in your browser (and on your device) and try again. If you're signing a past session where live location no longer makes sense, the EVV validation screen offers a checkbox to confirm it's a past session and bypass that specific check — use this only when it genuinely applies.
The session overlaps another signed note
To prevent double-billing, Alpaca checks whether the same clinician already has a signed note or verified appointment that overlaps this session's time. If it finds one, it will flag the overlap instead of signing. Fix the start/end time so the sessions don't overlap, or resolve the conflicting note, then sign again.
Co-treatment discipline not selected
If you've marked the session as a co-treatment, you'll be asked to choose the co-treatment discipline (for example OT or SLP) before you can sign. Select it and try again.
After you sign
A signed note is locked. If you spot a mistake afterward — wrong time, wrong details — you can reopen it using Modify Session, but because signed notes feed billing and payroll, changing one may require re-signing it. For corrections like a wrong session time, a wrong-staff signature, or a note on the wrong client, see the “Session Notes: Lifecycle and Troubleshooting” article.