Set Up Supervision – TherapyNotes

Any user in TherapyNotes may be assigned as a Supervisor for Clinicians or Interns. Supervisors may need to review their supervisees' notes or provide feedback on notes outside of a formal supervision session, and supervisees may even need to bill a service using their supervisor's credentials (also known as "incident-to" billing). This is especially effective when an intern is providing a billable service, although each payer will have their own guidelines on what qualifies as an incident-to-service. When in doubt, consult your contracts or contact the payer to verify eligibility to bill as a supervisor.

Supervisors in TherapyNotes may have the ability to access their assigned supervisees' notes, review and approve their supervisees' notes, or review and co-sign notes for their supervisees. You may also set whose information (the rendering provider, the supervisor, or both) is included on claims.

Assign Supervisors and Set Up Supervision

Role Required: Practice Administrator

Assign the Role of Supervisor to a User

Click Staff > Staff name
Click anywhere on the Roles box to edit the user's roles.
Select the Supervisor checkbox.
Click the Save Changes button.

Configure Supervision Settings for Supervisees

Click Staff > Staff name
Click anywhere on the User Information box to edit.
From the Supervision dropdown, select the appropriate supervision permissions.

Access patient notes and co-sign notes for selected payers: The Supervisor can view all client notes but does not approve or co-sign the note before it is entered in the client record. However, this setting may be overridden per payer.
Must review and approve all notes: Whenever the supervisee completes a note, a To-Do list item will be generated for the Supervisor to approve the note before it is entered in the client record.
Must review and co-sign all notes: Whenever the supervisee completes a note, a To-Do list item will be generated for the supervisor to co-sign the note. This action is required to bill under the supervisor's credentials.
- Once a level of supervision is selected, the Billing and Supervisors dropdowns appear.

From the Billing dropdown, select how the supervisee can bill insurance.
From the Supervisors dropdown, select the appropriate Supervisor for the supervisee. You may select more than one Supervisor as needed; the supervisee will need to choose which Supervisor is needed for each session in the header of the relevant note.
Click the Save Changes button.

If you selected Bill as clinician unless otherwise selected in a payer's settings from the Billing dropdown, follow the steps below to configure Bill as Supervisor per payer.

Edit Supervision Billing Settings Per Payer

Note: Only Practice Administrators who also have the role of Practice Biller may change Supervisor Billing settings per payer.

Click Staff > Staff name > Billing tab
Click anywhere on the Payers box to edit.

In the Supervisor Billing column, click the Supervisor Billing entry to display the dropdown, then select the preferred billing method from the dropdown.

Select Bill as Clinician to include only the rendering provider's information on claims OR

Select Include Clinician and Supervisor to include information for both the rendering provider and the supervisor, OR

Select Bill as Supervisor (Incident-To) to include only the supervisor's information.

Click the Save Changes button.

Configure Supervision for Specific Notes

Occasionally, you may need to update the Supervision settings for an individual note. Changes to supervision settings do not automatically apply to notes that were previously completed. For example, you may need to update a note completed before Bill as Supervisor was enabled, select between multiple assigned Supervisors, or make an adjustment after your billing or supervision settings have changed.

Role Required: Clinician (who originally created the note) or Supervising Clinician

Update Supervision Billing Settings on a Note

Click Patients > Patient Name > Documents tab.
Click the Edit icon (pencil) to the right of the note.
Click Edit in the upper-right corner of the note header.
Review the supervision information displayed in the note header.

When a supervisee opens an existing note for editing, the note header will automatically reflect their current supervision settings when applicable. For example, if Bill as Supervisor was enabled after the note was originally completed, the header may automatically update to display:

Supervisor: Supervisor's name
Signature Required: Billing as Supervisor

If the correct information is already displayed, no additional changes are needed.

If more than one Supervisor is assigned to the supervisee, select the appropriate Supervisor from the dropdown.
If your supervision settings are configured to Bill as Supervisor for selected payers rather than all payers, you may also need to manually select Billing as Supervisor from the Signature Required dropdown.
Click the Update Note Header button.
Re-sign and save the note.

After the supervisee re-signs the note, the Supervisor will receive a To-Do list item under Notes to Review to review and approve or co-sign the updated note. If billing as the Supervisor, the claim will be ready to bill once the required supervisory signature is completed.

Note: If changes are needed, the supervisee can edit a Progress Note even after it has been signed by the supervisor. Once the supervisee re-signs the updated note, the supervisor will be prompted to review and approve or co-sign it again.