This article is for providers using the Oasys web platform.
How practices set up clinical supervision in Oasys, how supervisees submit notes and assessments for review, how supervisors approve and co-sign, and how supervised sessions are billed.
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 therapist’s practice role is on the “requires supervision” list, every session note and diagnostic assessment they write goes through review — you don’t turn it on per patient.
It gates two things: clinical session notes (they move through an approval status instead of signing straight to locked) and diagnostic assessments / fillable-PDF documents (they can require a supervisor co-signature).
It can gate billing. By default a supervised session can’t be billed until the supervisor approves it (there’s a setting to allow billing earlier — see §7).
2. Turning it on & who manages it
Supervision is a practice feature that Oasys enables for your account — if you don’t see a supervision area, it isn’t switched on yet, so contact support. Once it’s on, it’s managed by a practice admin/owner (a clinician without admin rights can’t set up relationships).
Where: Practice HQ → the Clinical supervision tab. That tab has a Team view (current relationships, plus New assignment and Settings buttons) and a Settings view (roles, deadlines, and billing policies).
3. Setting up a supervision relationship
In Clinical supervision, click New assignment.
In the Create Supervision Relationship dialog, choose the Supervisor first, then the Supervisee.
If your practice allows more than one supervisor per supervisee, optionally toggle Set as primary supervisor (the primary is the default reviewer when a note is submitted without a specific supervisor chosen).
Click Create Relationship.
To end one, use End Assignment → End Relationship. This deactivates the relationship (it’s kept for history, not hard-deleted), and the supervisor’s access to that supervisee’s clients ends.
Critical - Set it up first
Supervision only applies to sessions that happen while the relationship is active. There is no way to retroactively mark a past session as supervised — if a therapist saw clients before their supervision was set up, those notes can’t be routed for review through the product (it takes a one-off engineering fix, which isn’t repeatable). Set up supervision before a supervisee starts seeing clients.
4. Choosing which roles need supervision
In Clinical supervision → Settings → Roles & assignments, two cards control who’s involved:
Supervising roles — the roles that can review and approve supervisees’ notes.
Requiring supervision — the roles whose notes must be reviewed by a supervisor.
A role can’t be on both lists at once. If you remove a role from a list, any now-invalid relationships in that capacity are automatically ended. (You also can’t change a therapist’s role out of a supervised/supervisor role while they still have active relationships — remove the connections first.)
The Settings view also holds the review deadline (default 48 hours, used for “overdue” flags), optional bulk sign-off controls, and the billing policies (§7).
5. The note review workflow
Supervisee: submit for review
When a supervised therapist finishes a session, the note’s button reads Sign and Submit for Review (instead of Sign and Lock for an unsupervised therapist). Submitting both signs the note and sends it to the supervisor; the note’s status becomes Pending Review. If the supervisee has more than one eligible supervisor and none is primary, they’ll be asked to pick one (“Multiple clinical supervisors are available. Please select one.”).
Supervisor: review the queue
Pending notes appear on the supervisor’s Supervision tab (“Supervision Dashboard”), with an overdue flag once past the deadline. Opening a note gives two actions:
Approve Session — marks it approved and notifies the therapist.
Request Revision — requires a comment (you’ll be prompted with “Comments Required” if it’s blank); the note goes to Needs Revision.
A note can be reassigned to another supervisor while it’s pending, but assignment is frozen once approved.
Supervisee: resubmit
A note in Needs Revision shows a Resubmit for Review button; resubmitting sends it back to the supervisor.
Practices with bulk sign-off enabled can approve or sign multiple notes at once from the dashboard.
Label to expect
The “pending” state shows slightly different words in different screens — Pending Review, Pending Approval, or just Pending. They mean the same thing (the canonical term is Pending Review); it isn’t a bug.
6. Reviewing & 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.
The supervisor reviews and signs them from their dedicated documents-to-sign queue — open the item, complete the supervisor signature fields, click Submit Form, then confirm on Confirm Supervisor Signature → Sign & Submit. A supervisor co-signature can’t be undone.
An Awaiting Supervisor row is not clickable from the patient’s documents list — it’s reviewed only from the supervisor’s queue.
Supervisors also have a compliance view where they can Flag as Required specific documents for each supervisee and track completion.
7. Billing under supervision
Billing is blocked until 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 with Allow billing before approval (“Supervisees can create claims and invoices while awaiting supervisor review”). A pending note is never auto-approved — it stays blocked until a supervisor acts.
Billing under the supervisor’s profile (incident-to)
Also in Billing policies, Bill under supervisor’s profile uses the supervisor as the rendering provider (Box 24j) on claims instead of the supervisee — this is incident-to billing. Because of this substitution, a supervisee does not need their own NPI; the supervisor must have an NPI on file (and, for practice-level incident-to, a taxonomy code). Oasys will surface an error if the supervisor is missing those.
Supervision modifiers (HO / HN / HP)
Supervised claims carry a modifier (commonly HO for an associate, HN for an intern). The modifier is now driven by Claim Rules (Practice HQ → Billing → Claim Rules). A practice that didn’t have a legacy modifier mapping needs to configure the supervision modifier there — 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 patients in that supervisee’s current caseload (their active clients) — not the whole practice.
Access is read for review plus the review actions themselves (approve, request revision, reassign, co-sign). It is not general edit access to the supervisee’s clinical record.
When the supervision relationship ends, that access ends. A former supervisor doesn’t keep visibility into the supervisee’s clients.
9. Group supervision meetings
Separately from client care, a supervisor can schedule and track group supervision meetings — supervisor-led sessions with their supervisees (therapist-to-therapist, never patient-facing). This is enabled by a Group Supervision Sessions toggle in the supervision settings. Don’t confuse it with group therapy (clients in a therapy group), which is a different feature.
FAQ & gotchas
A supervisee can’t submit a note for review.
The “Submit for Review” option only appears if the therapist was linked as a supervisee at the time of that session. If supervision was set up after the session, there’s no self-serve fix — set up supervision before seeing clients.
Can a supervised note be signed and locked normally?
No — for a supervised role there’s no separate “just lock it” path; signing routes it 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.
Who sets up supervision?
A practice admin/owner, 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/supervisee assignment, and support won’t add care-team members on your behalf.