The answer is HotKeys.
I do what you are doing, use my own superbill.
Try this and tell me if you have trouble making it work. I'll get on the phone w/ you and we'll talk it through if this is confusing.
Two reasons for using, forward an incomplete chart back to yourself in one key stroke, or saving the note in one keystroke.
The prompt for the referral letter could be removed using hotkeys as well, but I use it frequently. If you don't like it, press <ALT> + W to close that window in one keystroke.
The procedures for forwarding a chart to yourself:
1) Go to Autohotkey.com and down load and install the application.
2) It is a script to simulate clicking the buttons to forward the chart to your inbox, by pressing the <Windows Key> + <C> at the same time. It instantly performs the forward chart action.
3)Open Notepad and enter the following verbatim.
#c::
send !c,
send {down}
send {enter}
return
4) Save the file as ForwardChart.ahk
5) Drag the file to Start Menu-->Program Files-->Startup
The procedure for signing a chart:
1) After installing AutoHotkey application, Open Notepad and enter the following verbatim.
#s::
send !s!n!s{enter}!n!y
return
2)Save the file as SignNote.ahk
3)Drag the file to Start Menu-->Program Files-->Startup
By pressing the <Windows Key> + <S> at the same time, the note gets signed in 2 seconds or less.