This guide covers setting up clinical supervision workflows in your practice — including session review, approval processes, billing integration, and supervisor-supervisee relationships.
In this article:
1. Setting up supervision
Go to the Supervision section in your practice dashboard.
Enable supervision and configure which roles require it (e.g., associates, interns).
Define which roles can act as supervisors (e.g., licensed supervisors, senior therapists).
Set the approval deadline (default: 48 hours). You can set role-specific deadlines (e.g., interns get 24 hours, associates get 48).
2. Creating supervisor relationships
From your practice dashboard, go to Supervision.
Create a new relationship by selecting a supervisor and supervisee.
Choose the supervision type: Clinical, Administrative, or Both.
Set the frequency: Weekly, Biweekly, Monthly, or As Needed.
💡 Each supervisee can have one or more supervisors if you enable multiple supervisor support in settings.
3. How session review works
When a therapist who requires supervision completes a session:
Instead of Sign and Lock, the therapist sees Submit for Review.
The session is sent to their assigned supervisor with status Pending Review.
The supervisor receives a notification and sees the session in their pending reviews queue.
The supervisor reviews the notes and either Approves or Requests Revision.
If revisions are requested, the therapist edits and resubmits.
Once approved, the note is locked.
4. Supervision and billing
Supervision integrates with billing in two ways:
Billing modifiers — supervised sessions automatically include the appropriate modifier on insurance claims: HO (master's level), HN (bachelor's), HP (doctoral).
Billing gating — you can optionally block billing until a session is approved by the supervisor. Configure this with the Allow Billing Before Approval setting.
⚠️ If billing is blocked pending approval, sessions will show as "Blocked" in the Bill Sessions tab until the supervisor approves them.
5. Notification settings
Under supervision settings, configure:
Notify supervisor when a session is submitted for review.
Notify supervisee when supervisor takes action (approved or revision requested).
Reminder frequency for outstanding reviews: daily, weekly, or never.
6. Tracking outstanding reviews
Supervisors see pending reviews in their dashboard action items. Practice admins can view overdue sessions and outstanding notes stats across all supervisor-supervisee pairs.
Frequently asked questions
Can a therapist have multiple supervisors?
Yes, if you enable multiple supervisor support in your supervision settings. Contact support to set this up for your practice.
What happens if the supervisor doesn't review in time?
The system tracks overdue reviews based on your configured deadline. Reminders are sent automatically based on your notification settings.
Can I change who supervises a therapist?
Yes. You can update or deactivate supervision relationships at any time from the Supervision section.
Do billing modifiers apply automatically?
Yes. When a supervisee's session is submitted for billing, the appropriate modifier (HO, HN, HP) is added automatically based on their role.