If your Suki account is not integrated with your EMR you will have two options to finish your note.
You can sign off on your note
You can allow Suki to process your note
If you select Sign Note, you are letting Suki know that your note is completed to your satisfaction and the note will not be processed by Suki.
If you select Have Suki Process It First, your note will be sent to Suki for processing.