🖥️ For providers using the Oasys web app. Practice admins set supervision up in Practice HQ, and supervisors and supervisees then use it from their provider accounts.
This article explains how clinical supervision works in Oasys: how a practice sets it up, how supervisees submit notes and assessments for review, how supervisors approve and co-sign, and how supervised sessions are billed.
In this article
1. What supervision does
Oasys supervision routes a supervisee's clinical work to a supervisor for review before it's finalized. Three things to know up front:
It's role-based, not per-client. If a provider's practice role is on the Requiring supervision list, every session note they sign goes through review. You don't turn it on per client.
It covers two things: clinical session notes (they move through an approval status instead of signing straight to locked) and diagnostic assessments or fillable-PDF documents (they can require a supervisor co-signature).
It can hold up billing. By default, a supervised session can't be billed until the supervisor approves it. A setting allows billing earlier (see Billing under supervision).
There is only one kind of supervision relationship in Oasys: clinical. There are no administrative supervision types and no frequency setting to choose.
2. Turning it on and who manages it
Supervision is a practice feature, so a solo provider can't supervise without becoming a practice.
If it isn't turned on, the Practice HQ supervision page shows Feature Not Available ("The supervision dashboard feature is not enabled for your practice"). Contact Oasys support to turn it on.
Once it's on, it's managed in Practice HQ → Supervision (the page is titled Clinical supervision).
By default, practice owners and admins can open it. An owner or admin can also grant the Supervision permission to another team member under Permissions.
A clinician without that permission can't set up relationships.
The Clinical supervision page has two views:
Team: current relationships grouped by supervisor, plus New assignment and Settings buttons.
Settings: roles, deadlines, the multiple-supervisor rule, group supervision, and billing policies.
3. Setting up a supervision relationship
Set up roles first (see Choosing which roles need supervision). Until at least one supervising role and one supervised role are chosen, the page shows Configure roles first with a Configure Roles button, and New assignment is hidden.
Click New assignment in Clinical supervision.
Choose the Supervisor first, then the Supervisee, in the Create Supervision Relationship dialog. Only providers whose role is on the matching list appear.
Toggle Set as primary supervisor if your practice allows more than one supervisor per supervisee and you want this one to be the default reviewer. If multiple supervisors aren't allowed, the assignment automatically becomes the primary.
Click Create Relationship. The relationship starts today.
Managing an existing assignment
Each supervisee row has a menu (⋮):
Make primary: appears when multiple supervisors are allowed and this supervisor isn't already primary.
Remove assignment → End Supervision Relationship? → End Relationship: this deactivates the relationship. It's kept for history, not deleted.
You can't remove the primary supervisor while the supervisee has other active supervisors. Mark another supervisor as primary first.
If multiple supervisors aren't allowed and the supervisee already has one, creating a second shows "Multiple supervisors are not allowed for this practice. Please deactivate the existing supervision relationship first."
⚠️ Important: Set up supervision before a supervisee starts seeing clients.
A supervisee's note is routed for review at the moment they sign it. A note that was signed and locked before their role and relationship were set up is not re-routed.
Before ending a supervisor's assignment, make sure they have reviewed their pending notes. A submitted note stays assigned to the supervisor it was sent to, and once that relationship ends, no one else can approve it.
4. Choosing which roles need supervision
Roles decide who supervises and who is supervised. Set them in Clinical supervision → Settings → Roles & assignments, using two cards:
Supervising roles: "Select roles that can review and approve supervisees' session notes." At least one must be selected.
Requiring supervision: "Select roles that need their session notes reviewed by a supervisor."
A role can't be on both lists at once. It's greyed out on the other card.
If you remove a role from a list, any relationships that stop being valid are ended automatically.
You can't change a provider's role out of a supervised or supervisor role while they still have active relationships. You'll see "Cannot change role to … Remove the supervision connections first, then update the role."
Other settings in this view
Deadline Settings: a General review deadline in days (default 2 days, or 48 hours; 1 to 120 days) and optional Role-specific overrides. Notes not reviewed within the deadline are flagged overdue. Deadlines only drive overdue flags; nothing is approved automatically.
Multiple supervisors: "Allow providers to have more than one supervisor".
Group Supervision Sessions: see Group supervision meetings.
Billing policies: see Billing under supervision.
Bulk sign-off is set somewhere else: Practice HQ → Settings → Feature settings → Bulk sign-off. It has two switches, both off by default:
Bulk signing provider notes: "Allow providers to sign multiple session notes at once".
Bulk approval supervisee notes: "Allow supervisors to approve all pending supervisee notes at once".
5. The note review workflow
A supervised note moves from the supervisee to the supervisor and back until it's approved.
Supervisee: submit for review
Finish the session. The note's button reads Sign and Submit for Review (instead of Sign and Lock for an unsupervised provider).
Read the Submit session for review dialog. It explains that submitting will sign the session, notify your supervisor, and prevent further edits until the review is complete.
Click Submit for review.
If you have one supervisor, the dialog shows Submitting to: their name.
If you have more than one and none is primary, pick one from the Supervisor list. The primary is marked (Primary).
If no supervisor is assigned to you, the dialog shows "No eligible clinical supervisor is currently available for this session." and you can't submit. Ask your practice admin to create your supervision relationship.
The note's status becomes Pending Review. If bulk signing is on, the Unsigned Notes window has a Bulk Sign (N) button.
Supervisor: review the queue
Supervisors (any provider whose role is a supervising role) have a Supervision tab in the left sidebar, with a badge showing how many items need action. It opens the Supervision Dashboard:
Summary cards: Pending review (finalized notes awaiting your review), Overdue notes (past the supervision deadline), and Documents to sign (documents awaiting your supervisor signature).
Your supervisees list. Select a supervisee to see their Caseload, Recent Activity, and Sessions to Review, filtered by All, Pending, Approved, Needs Revision, and Overdue.
A Compliance button, if your practice uses document requirements (see Reviewing and co-signing diagnostic assessments).
Pending counts only include notes for active clients.
Opening a note shows the clinical note (or the provider's original notes) and the session's Risk Assessment and Mental Status Exam, so you can review risk and MSE without leaving the note. If neither was filled in, you'll see "No Risk Assessment or Mental Status Exam recorded for this session." Below them are a Review Comments box and two actions:
Approve Session: marks the note approved and notifies the provider.
Request Revision: requires a comment (you're prompted with "Comments Required" if it's blank). The note goes to Needs Revision and the provider is notified.
Only the supervisor a note was submitted to can act on it. Another supervisor opening it sees "Review actions are unavailable because this session is assigned to …".
There is no reassign button. A submitted note can't be moved to a different supervisor.
If your practice has bulk approval on, the Pending filter shows Approve All (N) for the selected supervisee.
Supervisee: resubmit
A note in Needs Revision shows the supervisor's comments under Supervisor Feedback, plus Edit and Resubmit for Review buttons. Resubmitting sends it back to the same supervisor with the status Resubmitted.
Notifications
Supervisors are notified when a note is submitted to them. Supervisees are notified when a note is approved or sent back. Turn these on or off in Settings → Notifications, under Supervision.
✅ Good to know: The pending state shows slightly different words on different screens: Pending Review, Pending Approval, or just Pending. They all mean the same thing (Pending Review).
6. Reviewing and co-signing diagnostic assessments
Diagnostic assessments and other fillable-PDF documents a supervisee completes can require a supervisor co-signature. Those documents show the status Awaiting Supervisor.
Open the item from the Supervision Dashboard: Documents to sign, or Review & Sign on the supervisee's pending documents. If your practice uses document requirements, this opens the Compliance view filtered to that document.
Complete the supervisor signature fields and click Submit Form.
Confirm on Confirm Supervisor Signature → Sign & Submit.
A supervisor co-signature can't be undone.
An Awaiting Supervisor row can't be opened from the client's documents list. It's reviewed only from the supervisor's Supervision tab.
In Compliance, supervisors can also Flag as Required specific documents for each supervisee and track completion and due dates.
7. Billing under supervision
Supervision affects when a session can be billed and whose details go on the claim.
Billing waits for approval, unless you allow it earlier
By default, a supervised session can't be billed until the supervisor approves the note. You'll see "Session awaiting supervisor approval before billing."
A practice can change this in Clinical supervision → Settings → Billing policies → Edit → Allow billing before approval ("Supervisees can create claims and invoices while awaiting supervisor review").
A pending note is never approved automatically. It stays blocked until a supervisor acts.
In Practice HQ billing, clicking a Blocked supervised session tells you who needs to approve it:
Waiting for supervisor approval: names the supervisor who needs to approve the note in Supervision.
No supervisor can approve this session: no active clinical supervisor is assigned to the session, so it can't be approved or billed yet.
Billing under the supervisor's profile (incident-to)
Also in Billing policies, Bill under supervisor's profile ("Use the supervisor as the rendering provider (Box 24j) on claims instead of the supervisee") is incident-to billing.
Practice-level insurance billing: the practice stays the billing provider and the supervisor becomes the rendering provider. The supervisor needs an NPI and a taxonomy code. Otherwise you'll see "… must have a taxonomy code configured to be used as the rendering provider for practice-level incident-to billing."
Solo billing (no practice insurance billing): the supervisor becomes the billing provider, so the supervisor needs an NPI and Tax ID in their insurance profile. Otherwise you'll see "Supervisor's insurance info (NPI and Tax ID) is required for incident-to billing."
Every supervised claim, with or without incident-to, needs the supervisor to have an NPI ("… does not have an NPI configured. A supervising provider NPI is required for supervised claims.").
Supervision modifiers (HO / HN / HP)
Supervised claims can carry a modifier, commonly HO for an associate or HN for an intern. The modifier comes from claim rules:
Go to Practice HQ → Billing → Claim rules.
Create a rule with the condition Supervised (and optionally Supervisee role).
Choose the action Add modifier.
If your supervised claims don't already carry a supervision modifier, set one up this way. It isn't applied by default.
8. What a supervisor can see
A supervisor's access is deliberately narrow.
They can see and review work only for their current supervisees, and only for the clients in that supervisee's current caseload, not the whole practice.
The caseload is the clients the supervisee actually works with: their active clients, care-team clients they see sessions for, and their active couples and families.
For each of those clients, the supervisor can open General, Sessions, and Documents views, with clinical and personal details.
Access is read-for-review plus the review actions themselves: approve, request revision, co-sign, flag required documents, and complete supervisor fields on documents. It is not general edit access to the supervisee's clinical work.
When a supervisee moves to a different supervisor, the former supervisor loses all access. The supervisee is removed from the former supervisor's Supervision dashboard, and they can't see anything related to that supervisee.
9. Group supervision meetings
Separately from client care, a supervisor can schedule and track group supervision meetings: supervisor-led sessions with their supervisees (provider-to-provider, never client-facing).
A practice admin turns this on with the Group Supervision Sessions switch ("Allow supervisors to create and track group supervision meetings") in Clinical supervision → Settings. The supervisor's Supervision Dashboard then shows a Group Supervision Sessions section:
Click New (or Create Group Session).
Enter a Session Name, Date, Start Time, and End Time, choose the supervisees, and optionally add Notes.
Click Schedule Session for a future time, or Log Session for one that has already happened. Past sessions are completed as soon as they're created.
Each meeting shows Scheduled, Completed, Cancelled, or Unaddressed (a past meeting still marked scheduled).
From a meeting, you can mark each supervisee Attended or Absent, Mark Complete, or Cancel Session.
Don't confuse this with group therapy (clients in a therapy group), which is a different feature.
Frequently asked questions
Why can't a supervisee submit a note for review?
If the dialog says "No eligible clinical supervisor is currently available for this session.", the supervisee's role requires supervision but they have no active supervisor. A practice admin needs to create the relationship (see Setting up a supervision relationship). If the note was already signed and locked before supervision was set up, it isn't re-routed.
What does "Multiple clinical supervisors are available. Please select one." mean?
The supervisee has more than one supervisor and none is primary. Pick a supervisor in the submit dialog, or have an admin use Make primary on one of them.
Can a supervised note be signed and locked normally?
No. For a supervised role there's no separate "just lock it" path. Signing routes the note to review in the same step.
Does the note get approved automatically if the supervisor is slow?
No. Deadlines only drive overdue flags. A note stays pending (and billing stays blocked, unless you've allowed billing before approval) until a supervisor acts.
Why don't I see a Supervision tab?
Providers see it only if the practice has supervision turned on and their role is a supervising role. Supervisees don't get the tab; they see review status on their notes.
Who sets up supervision?
A practice owner or admin (or someone granted the Supervision permission), in Practice HQ. Adding a co-treating clinician to a client's care team is a separate, admin-only action. It's not the same as a supervisor and supervisee assignment.