This article is for providers using the Oasys web platform.
Oasys handles more than one-to-one adult clients. This covers the different client and session types — group therapy, couples, families, and minors with guardians — how to set each up, and where billing and access work differently.
1. The client types (and how they differ)
A useful mental model: in Oasys, a client is always an individual person. “Couple,” “family,” and “group” aren’t a field on that person — they’re containers that group individuals together, and “minor” is a setting on the person’s account. When you create a client, the account type options are:
Type | What it is | How to enable it |
Adult | A standard individual client. | Always available. |
Minor | A child/dependent whose account a parent or guardian manages. | Always available. |
Couple | Two partners seen together (a container linking two individuals). | Oasys enables it for your practice (support/admin) — not a self-serve toggle. |
Family | A family unit (a container of 1–10 individuals). | Same as couples — support/admin enables it. |
Group | A roster-based therapy group with its own recurring sessions. | Turned on for your practice first, then each therapist has a Group Therapy Sessions toggle in Settings. |
There is no “change client type” field
Because these are containers, you don’t convert a person’s type on their profile. To see two existing clients as a couple, you create a couple that links them (§5); to run a group you build a group roster (§7). The one exception is minor, which is an account setting chosen at creation (§2).
2. Minors & guardians
Creating a minor
Choose the Minor account type when adding a new client (My Clients → Add a New Client). You’ll enter the child’s details and a guardian; the guardian receives an email with login credentials and manages the child’s account.
You can also convert an existing client to a minor — but only before a portal invite has been sent to that client, and only by a therapist with direct access to them. Once an invite has gone out, the account type can’t be changed in the product.
Support-only
Converting an already-invited client to a minor, and bulk-converting many existing clients to minors, aren’t self-serve — they require a support/engineering action (with each child’s full guardian info on file first). Bulk conversions should be requested as one batched list, not done piecemeal.
Guardians: one or more, one primary
A minor’s account can have one or more guardians, with exactly one primary. You add and manage them from the minor’s profile (there’s an add-guardian flow, and a set primary action). Guardian portal permissions must be set before an invite is sent.
A logged-in guardian can see all guardians but edit only their own entry. A minor with their own login sees the guardian list read-only.
Removing a guardian also revokes their access to the minor’s documents.
Guardian vs emergency contact
These are separate records. A guardian has a portal login and receives the minor’s invoices and notifications (per the access areas below). An emergency contact is just contact information — no portal access. Adding one doesn’t create the other.
3. Portal access for minors
Access to a minor’s portal is split into four areas, and each can be granted to the minor, the guardian, or both:
Clinical info (treatment plan, insights, mood/diary/worksheets, health data)
Messaging
Scheduling
Billing & insurance (invoices, payment methods, insurance, superbills, estimates)
Why “Add Patient” is greyed out for a minor
Every one of the four areas must be assigned to at least one person (the minor or a guardian). If any area is left unassigned, the Add Patient button stays disabled. Checking the guardian (and/or minor) for all four areas is what activates it. A full add-minor flow: Add Patient → select Minor → choose therapist → enter the minor’s name → enter the guardian’s name → check Guardian has portal access → enter the guardian’s email → check all four access areas → Add Patient.
4. The account switcher
When one login is tied to more than one account — a guardian who manages a child, or a guardian who is also a client themselves — a Switch account control appears (top right). Each account carries a badge: Self or Minor, and Setup needed if onboarding isn’t finished.
The most common minor-billing confusion
Everything a guardian does — adding a card, completing documents, paying invoices — applies to whichever account is active. To manage the child’s billing, the guardian must Switch account into the minor’s account first. If they do it from their own account, it changes their own settings instead, with no warning. And if a guardian sees “Your therapist needs to complete their payment setup” but the therapist’s Stripe is active, they’re almost always in the wrong account — check the Self / Minor badge.
If a guardian doesn’t see a Switch account option at all, either the child account/invite isn’t finished, or the guardian’s login isn’t linked to the minor yet (that link sometimes needs support to repair).
5. Couples
Creating a couple
A couple links exactly two individual clients — it doesn’t merge their accounts; each keeps their own profile. From the client list, Add New Client → Couple, then for each partner choose Existing Client (or create a new one). This creates a distinct couple record for managing them together.
Scheduling a couples session
You need a service that’s allowed for couples first (a service with Couple checked under “Can be scheduled for”). Then book from the couple — the couple appears as its own subject (a Couples entry) when choosing who an appointment is for, and the couple’s record has its own session area. A couple won’t appear through the normal one-client scheduling flow.
Who’s billed
One partner is the account lead and receives all of the couple’s invoices (you can change who that is, with a confirmation, since it repoints billing). A Billing enabled switch lets you pause invoices and claims for the couple.
6. Families
A family is like a couple but holds 1–10 members. When you create it (Add New Client → Family), you name it and set its first member as the account lead; additional members are added afterward from the family’s profile. Billing works the same as couples — the account lead receives invoices, with a Billing-enabled switch.
“Not authorized to attach this patient to a family”
Attaching an existing client to a family is only allowed if you’re on that client’s care team / are their assigned therapist. If a different therapist is their primary, the attach is blocked with that message today. (A cross-therapist version was described as coming soon.)
7. Group therapy
First: a group service type
A group needs a service created in the Group Session format (Settings → Default Services → add a service and choose the group format). Only those services appear when you pick a group’s service type. A service’s format is fixed once created — to change it you create a new service.
Creating the group
Open Create Group and set a Group Name, Purpose, and a group Service Type.
Add members — between 2 and 10 (a CMS cap).
Optionally add co-facilitators. Note two rules: every co-facilitator must be on each selected member’s care team, and co-facilitators are locked once the group is created (you can’t add, change, or remove them later).
The group gets a persistent video room reused across every session.
Running a session
Group sessions are telehealth or in-person only (no phone).
You mark attendance per member (present / absent). No-shows are tracked and can carry a no-show fee, but get no clinical note or claim.
Notes have two levels: a shared Group Notes field, plus a per-participant note for each attendee (an AI-drafted note you review and sign individually). Generate notes drafts one per attendee; Sign and Lock All Notes signs them in bulk.
Supervised therapists: In the current version, supervised therapists can’t run group sessions.
8. Billing across client types
Couples & families — billed to the single account lead; other members aren’t billed directly.
Groups — billed per attendee: each attendee’s portion follows their own billing type (cash-pay or insurance), and every group charge is attributed to the group’s primary provider (even if a co-facilitator ran the session). Group claims use group CPT codes (e.g. 90853 for group psychotherapy).
Minors — billed inside the minor’s account; set up payment there (via the account switcher), and the minor’s billing emails go to the guardian. See the Billing article for the full minor/alternative-payer/card-on-file flow.
Two parents / split billing
Only one external-payer “Card on File Request” can be open per client at a time (“a request is already waiting for an external payer”). To collect cards from two parents, wait for the first to complete before sending the second. A client can have multiple cards on file once added — just not two pending requests at once.
FAQs
The same email is rejected when inviting a client.
An email can be reused for a minor’s account and that same person’s own guardian account — but the same email can’t belong to two separate adult (“self”) accounts. A failed invite usually means that email is already tied to another adult client.
Can I turn an individual into a couple/family myself?
If Couples/Family is enabled for your practice, yes — you create a couple/family that links the existing clients (§5, §6). If those options don’t appear at all, the feature isn’t enabled for your practice yet — contact support.
Why can’t I pick a group service?
You need a service in the group format first (§7). If you’re a practice admin and group services you create don’t show up, that admin-portal path had a bug that’s since been fixed.