🖥️ For providers using the Oasys web app. If you're in a practice or on Managed RCM, some of these settings are managed for you (see Your Oasys subscription).
This article walks you through getting billing ready before your first session: Billing setup, connecting Stripe, insurance billing, client insurance details, billing types, custom pricing, and billing for minors.
In this article
1. Billing setup: the basics
Billing setup is where you get your account ready to bill. Find it at Billing → Billing setup (under Setup in the left sidebar). It has three numbered steps:
Provider information.
Payment processing.
Insurance billing (only appears if insurance billing is available on your account).
Each step unlocks when the one before it is done. For example, Payment processing shows "Save your provider information to unlock this step." until you've saved your provider details.
💡 Tip: For a guided tour on sample data, click Take the billing tour at the bottom of the Billing sidebar.
Your browser's Back button steps back through the Billing sections you visited (for example, from Manage invoices back to Bill sessions), rather than leaving Billing altogether.
Cash pay only?
If you don't bill insurance, turn on Cash pay only in the Insurance billing step and confirm.
This hides the insurance sections (Manage claims, Eligibility checks, Payment remittances, Accepted payers) from your Billing tab.
The Insurance billing type shows (Cash pay only) and can't be chosen.
You can turn it off at any time to bring them back.
2. Setting up payment processing
Connect Stripe to collect card payments from clients. Go to Billing → Billing setup → Payment processing.
Click Connect Stripe Account.
Complete Stripe's onboarding: business info, banking details, and tax ID. It takes about 5 minutes.
Check the status. When it's done, it reads Active, with checkmarks for Accept Payments, Receive Payouts, and Account Details. If it still says Setup Incomplete, click Complete Setup to finish.
Once you're active, the Dashboard button opens your Stripe dashboard. You set your payout schedule and timing in Stripe, not in Oasys (see Stripe's payout schedule instructions). Your payout history is also in Stripe.
Until Stripe is set up
Some parts of Billing stay locked until Stripe onboarding is finished.
A Pending badge shows on Billing in the left sidebar and on Billing setup.
Manage invoices stays locked ("Billing setup is pending. Finish Stripe onboarding to unlock this section.").
If you do reach Manage invoices before Stripe is connected, Create Standalone stays unavailable ("Finish payment setup to create invoices.").
⚠️ Important: Payment processing is not your Oasys subscription. The Billing tab is how you collect money from clients. Your Oasys plan (Settings → Subscription) is separate: see Your Oasys subscription.
3. Setting up insurance billing
Before submitting insurance claims, set up your provider information and your accepted payers.
Provider information
Go to Billing → Billing setup → Provider information and fill in:
Provider type: Individual or Organization/Group.
NPI: your 10-digit National Provider Identifier.
Tax ID: your EIN or SSN (organizations must use an EIN).
Provider taxonomy: your taxonomy code.
Accept Assignment: whether you agree to take Medicare's approved amount as payment in full.
Billing contact (name, email, phone) and billing address. Start typing the street address to pick a US address from the suggestions, or type it in yourself.
Click Save Provider Details when you're done. If you've already filled out your provider profile, some fields are pre-filled for you.
Accepted payers
Add the insurance companies you bill, in the Insurance billing step of Billing setup.
Click Add accepted payer. The button unlocks once Stripe is active and a valid NPI is saved. You can also manage payers any time from Billing → Accepted payers.
Search for insurance companies by name and add them.
Enroll each payer for the transaction types you need:
1500 (Claims): submit CMS-1500 claims electronically.
ERA: receive Electronic Remittance Advice (payment notifications).
Eligibility: verify client insurance coverage online.
Enrollment is processed through our clearinghouse, and timelines vary by payer. A payer can show Pending or Action Required while it's being set up. Open Accepted payers and click into any payer marked Action Required to see what's needed.
⚠️ Important: After a payer is accepted, it can take extra time to fully activate for claims and ERAs. Eligibility checks may start working before claim submission does. You can't submit a claim for a client whose payer isn't on your Accepted payers list.
Payer statuses and enrollment
Each payer on Billing → Accepted payers shows a badge for Claims, ERA and Eligibility. Hover a badge to see what it means.
Badge | Meaning |
Available | Ready to use. No extra setup is needed. |
Enrolled | Enrollment is approved and ready to use. |
Not Enrolled | You need to enroll before you can use it. Click Enroll. |
Pending | Enrollment was submitted and is being processed. |
Action Required | The enrollment needs something from you. Click Review. |
Not Supported | This payer doesn't offer this electronically. |
Status Unknown | The enrollment status isn't available yet. |
To enroll a payer:
Click Enroll next to the payer.
In Select Enrollment Type, choose Enroll for Claims (CMS-1500), Enroll for Electronic Remittance Advice (ERA) or Enroll for Eligibility Verification. Only the types that still need enrolling are offered.
Check that the status moves to Pending.
Medicare payers may ask for your Medicare PTAN (4-10 letters or numbers). It's used for Claims and ERA enrollment. You can find it on your PECOS record or your Medicare contractor's approval letter.
Use the status filter to show Action required or Needs enrollment payers only.
For Action Required, click Review (or View Enrollment History in the payer's three-dot menu). Click View enrollment steps to see what the payer needs. When you've finished those steps, tick I've completed these steps and confirm, so the payer can finalize your enrollment.
If an enrollment is rejected or canceled, the history shows the reason and the payer goes back to Not Enrolled, so you can fix the issue and enroll again.
To take a payer off your list, open its three-dot menu, choose Remove Provider and confirm.
⚠️ Important: Once ERA enrollment is active for a payer, all its remittances come through Oasys. Your previous clearinghouse stops receiving ERAs for that payer.
Payer not found, or claims going to the wrong payer
Use this when you can't find a payer or a claim was sent to the wrong one.
If the search shows No insurance providers found, try the payer ID from the client's card as well as the name. If it still isn't there, contact Oasys support with the payer's name and payer ID. Don't switch the client to cash pay just to get past it.
A claim blocked with "Provider does not accept this payer" means the client's payer isn't on your Accepted payers list. Add it (and enroll for Claims if needed), then bill the session again.
Each claim goes to the payer on the client's insurance at the time the claim is created. If that payer is wrong, fix it in the client's insurance (not just on the claim) so the next claim goes to the right place, then resubmit. See Correcting, resubmitting or voiding a claim.
4. Entering client insurance information
Add a client's insurance so you can check eligibility and send claims. Go to Billing → Client billing, open the client, and go to Settings → Insurance. If an insurance client's details are missing or incomplete, you can also click Add insurance or Finish setup on their row.
The wizard walks through up to five steps:
Enter the Insurance information: provider, Member ID, Group Number, subscriber relationship, optional card photos, optional secondary insurance.
Enter the Client information: name (must match the insurance card exactly), sex (required for verification), date of birth.
Fill in Subscriber information, only if the client isn't the primary subscriber (spouse, child, and so on).
Add the Client address: a valid US address that matches what the insurer has on file. For most insurance claims it can't be a PO Box.
Check the details on Review & verify. Optionally click Verify Eligibility to check coverage (or Re-verify to run it again), then save the insurance information. If real-time checks aren't available for that insurance company, you'll see a note saying so. The client's information is still saved.
💡 Tip: Complete the subscriber step. If a subscriber is selected but the subscriber details are left blank, claims can come back rejected, sometimes with a misleading error such as "incorrect ZIP code." If a claim is rejected and everything else looks right, check that the subscriber information is fully filled in.
Illinois Medicaid: the Medicaid RIN
For Blue Cross Community Health Plans Illinois Medicaid and Illinois fee-for-service Medicaid, a Medicaid RIN field appears below Member ID.
Enter the subscriber's nine-digit RIN, including any leading zeros. Keep the card's Member ID in Member ID, since it's used for eligibility checks.
If the Member ID is the RIN, select Member ID is also the Medicaid RIN. The separate RIN field is hidden and the nine-digit rule applies to Member ID. Clear the box to enter a separate RIN.
Enter the RIN separately for primary and secondary coverage. A required RIN must be filled in before you can finish insurance setup or submit claims.
For Meridian Illinois, Aetna Better Health of Illinois, CountyCare and Molina Illinois, the RIN is optional. Claims use it when it's there, and use the Member ID otherwise.
The RIN belongs to the subscriber: your client with Self, or the person whose details you enter with Child, Spouse or another relationship. Entering it doesn't change the relationship on the claim.
After you save, insurance summaries and the review step show the RIN next to the Member ID.
⚠️ Important: Oasys doesn't check whether the coverage and subscriber relationship you choose meet the payer's Medicaid requirements. Confirm those with the payer.
5. Choosing a client's billing type
Each client has a billing type: Insurance, Cash Pay, or Not Billed. Set it in Billing → Client billing (the billing-type dropdown on the client's row), or in the client's chart under Preferences.
A session only appears in Bill sessions when the client is Cash Pay or Insurance.
A client you add defaults to Cash Pay (this includes minors).
Insurance is greyed out until your insurance setup is ready. You'll see why next to it: (Setup required), (NPI required), (Practice setup required), or (Cash pay only).
Clients brought over from another system during a migration come in as Not Billed. Switch them to Cash Pay or Insurance before their sessions can be billed.
There's no bulk billing-type editor. If a large number of migrated clients need switching at once, contact Oasys support.
6. Custom pricing per client
Use a pricing rule to override your default rates for a specific client.
Open the client's billing panel: Billing → Client billing → the client → Settings → Pricing rules.
Click Add Rule and choose the appointment type.
Set a Session price, No-show fee, Late-cancellation fee and optional CPT override, separately for telehealth, in-person and phone sessions. Leave phone blank to use the telehealth pricing.
Set Effective from (and optionally Expires after), then click Create rule.
Client-specific pricing takes priority over your default service rates.
💡 Tip: Pricing rules honor a start date. A rule applies to unbilled and unclaimed sessions on or after its Effective from date. The session's date decides the price, not today's date, so earlier sessions bill at your default rate.
To apply a special rate to an earlier session, edit the rule and set Effective from back to that date. Invoices and claims already sent don't change.
Leave the late-cancellation fee blank to use your default pricing, or tick Waive under it to charge $0. The no-show fee and the late-cancellation fee each have their own Waive box.
An amount you set by hand on one appointment takes priority over the rule. Clearing it brings back the calculated price. Rule changes apply to matching unbilled appointments; invoices already sent keep their amounts.
Deleting a rule makes it inactive. Unbilled sessions fall back to your other rules or default prices, and existing invoices and claims don't change.
To charge a different no-show fee for one appointment only, open it on your calendar and edit the No-Show Fee in its billing details. A fee saved on that session takes priority over the pricing rule and your default.
7. Billing for minor and dependent clients
A minor client has their own account that a parent or guardian manages, and billing is scoped to that account.
Set up billing in the minor's account
A guardian who also has their own Oasys account must use Switch account to move into the minor's account before adding a card. Anything done in their own account applies only to their own billing.
"Your provider needs to finish setting up payments before you can add a payment method" usually means one of two things: the provider (or practice) hasn't finished Stripe onboarding, or (very often) the guardian is in the wrong account. Check the Self/Minor badge and switch accounts.
Who pays
The guardian chooses in the portal under Payments → Payment Settings → Who Pays for Your Sessions?: Myself (Parent/Guardian), or Another person (parent, spouse, etc.) (an alternative payer).
You can also set this for them in the client's billing panel → Settings → Billing settings (Parent/Guardian (Direct) or Alternative Payer).
To add an alternative payer there, click Add contact. Adding a payer doesn't make them the billing contact. Choose Set as Billing Contact from their menu when you're ready.
Saved cards belong to each payer. Charge card automatically is one setting for the whole client account, controlled by you. Switching payers doesn't turn it off, and guardians can't change it themselves.
Removing an alternative payer sends billing back to the client (or guardian). Their contact details and history are kept.
Collecting a card on file
In the client's Billing settings, click Send request.
If the billing contact is the client (or guardian) with a portal login, they get a Card on File Request in their portal Documents.
If the billing contact is an alternative payer, they get a secure link (no account needed) that expires after 14 days.
Only one such link can be open per client at a time. To collect from two payers, wait for the first to finish (or Cancel request) before sending the second.
While a request is pending, you can Send reminder or Cancel request.
Frequently asked questions
Is payment processing the same as my Oasys subscription?
No. Payment processing (Stripe, set up in Billing setup) is how you collect money from clients. Your Oasys plan is managed in Settings → Subscription.
Why can't I choose Insurance as a client's billing type?
Your insurance setup isn't ready yet. The label next to Insurance tells you why: (Setup required), (NPI required), (Practice setup required), or (Cash pay only).
Why can't I add an accepted payer?
Add accepted payer unlocks once Stripe is active and a valid NPI is saved in Provider information.
Does a pricing rule change sessions I've already billed?
No. A rule applies to unbilled and unclaimed sessions on or after its Effective from date. Invoices and claims already sent don't change.