EHR

Simple Practice EHR Pros and Cons – the Professional Plan $59/month

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In this blog post I share my experience with Simple Practice with some comparison to TherapyAppointment.com’s Legacy system.

I highly recommend simplifying your private practice by using an EHR as soon as you can afford it. For the cost of less than one session per month, you can present your practice to clients professionally with an EHR Client Portal and e-signature forms, and streamline your practice management to save significant time and money.

During the coronavirus pandemic, using the Simple Practice EHR with e-signature for clients to complete documents made it possible for me to quickly adapt to telehealth only. I didn’t miss a beat in terms of appointments and scheduling new clients when the shelter-in-place directives came down in March 2020.

My experience with Simple Practice comes from using it as a solo practitioner since Fall 2019.  It served me well in the office pre-pandemic and continues to be excellent for my current exclusively telehealth practice. Despite some non-intuitive workflows and idiosyncrasies that take time to figure out, I highly recommend Simple Practice. 

Start your free first month of Simple Practice here and receive $50 credit for your first paid month with my discount code – I get a $50 credit, too ;-).

Previous to Simple Practice, I used TherapyAppointment.com (TA) (the Legacy system) for charting and electronic claims submission integrated with Office Ally (OA). 

Switching to Simple Practice was a vast improvement over TA’s Legacy system in terms of charting, telehealth practice in general, and electronic submission to secondary insurances. 

When I left TA I had been waiting for over a year for the transition to the new TA 2.0. which would have been comparable to Simple Practice. I got tired of waiting and I am so glad I made the transition to SP before the coronavirus pandemic. 

If you have more than just a few clients, I highly recommend using an electronic health record (EHR) for time management (high on my list of priorities) and efficiency/accuracy of charting (also high on my priorities list).  In addition, the ease of integrated electronic claim submission and client billing is a big time saver not to mention the money saved doing your own billing. 

Start your free first month of Simple Practice here and receive $50 credit for your first paid month with my discount code

Simple Practice Pros and Cons

This list is not exhaustive of all the pros and cons of Simple Practice. These are a few notes, in no particular order, from my experience.

CLIENT PORTAL

Pros: 

  • The Simple Practice Client Portal is great for getting documents electronically signed by clients, sharing .pdfs (to and from clients), secure text messaging with clients, and receiving payments from clients (Stripe is integrated for online payments).
  • When a client shares a document (they can upload photos and documents easily) with you or completes the documents you have sent to them, you get an email notification.

Cons:   

  • There’s no notification outside the system when a client sends you a secure text message within the system.
  • Regarding the documents you send to clients for review, e-signature, and filling out, there are two distinct processes you must learn. Learning the difference between the two and which forms are under each heading takes some time. It’s not 100% intuitive.
  • Secure Messaging via the Client Portal is difficult to deal with for the client. The secure link sent to the client when a clinician sends a message to the client is time limited. If the time expires, the client has to figure out how to get into their client portal.  There’s no client facing app.  My clients don’t use the secure messaging feature. It’s too complicated.  If it was an app on their phone some of them would probably use it.

SCHEDULING

Pros: 

  • The schedule is relatively easy to manage.  
  • There is an option to allow clients to schedule online via a booking widget.
  • You can create multiple offices (for in office visits, home visits, telehealth, etc). This way you can assign the proper office to each individual client so the Place of Service is always correct (i.e. 02, 11, 12, 13, etc) on the claim.
  • You can sync the calendar with your Google calendar (and possibly other calendars).

Cons: 

  • The appointments on the calendar are not easy to identify in terms of which office the client is scheduled for (in office vs home visit, etc) – there is a color coding line on the edge of each appointment but it is difficult to see. This means you need to memorize the color for each office type.  If you use SP’s Telehealth platform it automatically assigns Place Of Service 02 to claims and there is an icon indicating a video camera which is pretty much the only obvious office assignment. 
  • The automatic POS 02 with the Telehealth option means if you are using SP Telehealth but that when a client’s insurance (e.g., Medicare) requires POS 11 with a modifier for telehealth then, you have to change the POS on each claim (too easily forgotten prior to submission and extra time/effort).

CREATING DOCUMENTS, INFORMED CONSENTS, ASSESSMENTS, TREATMENT PLANS, AND PROGRESS NOTES – this is one of the best parts of Simple Practice!

Pros: 

  • There is a large library of documents, assessments, progress notes, informed consents, etc., that are customizable (with Professional Plan) or you can start with a clean slate and create new documents from your own existing documents.
  • Looking up diagnosis codes is fairly straightforward.
  • Treatment plan reminders give you a head’s up when you need to update.
  • Treatment plan development – Wiley Planners are currently included free (as of October 2020).  You can select from many suggestions for creating a client specific treatment plan.

Cons: 

  • Unbillable diagnostic codes are not available to be listed which requires the clinician to add it to the progress notes within the body of the note.
  • There are two processes to learn to create documents.

REMINDER MESSAGES (voice, text, email)

Pros: 

  • Included in the monthly price (not an add on like other EHRs). 
  • You can edit the email, text, and voice messages to include practice specific information. For example, I use doxy.me for telehealth rather than S.P. Telehealth platform.  I’ve included my doxy.me waiting room link in reminder email messages for telehealth appointments.
  • Appointment Confirmations are a new feature.
  • Reduces No Shows. 

CLAIMS PROCESSING

Pros:

  • Claims processing is optional.
  • You can choose to be charged per claim or a package deal.
  • Inexpensive compared to paying a billing agency.
  • Current choices (claims over the package limit are processed at 25c per claim): 
    • 25c per claim
    • 25 claims for $6/month (24c/claim)
    • 50 claims for $11.50/month (23c/claim)
    • 100 claims for $22/month (22c/claim)
    • 200 claims for $42/month (21c/claim)
    • 400 claims for $69/month (17c/claim)
  • ERAs (Electronic Remittance Advice) are now available for download.
  • You can grant your biller access to deal with billing.

Cons:

  • The Medicare ERA doesn’t tell you if and where the claim was forwarded for secondary insurance processing (for comparison, Office Ally’s ERA includes all information).
  • Clinicians have no direct access to the clearinghouse that SP uses.
  • Claims processed from Medicare don’t automatically adjust the Contractual Obligation (CO). You must do this manually for each Medicare claim. Claims processed from other insurance companies do generally automatically adjust the CO.
  • If there is an amount owed by the client, deductible or coinsurance for example, there is no specific notification process.  The information is there but it’s not obvious.
  • The process to get set up with each insurance company for processing via SP’s clearinghouse is a bit labor-intensive.  By comparison, Office Ally and TherapyAppointment.com were much easier.
  • Medicare + Secondary claims:  If a client has a secondary insurance to Medicare, when the secondary ERA is processed it is listed in SP as being from Medicare (you cannot correct this in the client’s account but you can correct it under the Payments list).  This is a serious issue with inaccurate information being reported to the clinician. Each payment from a secondary in this situation has to be verified elsewhere then corrected in the Payments part of the system. 
  • Appointment Status feature is difficult to follow and not always accurate in terms of Paid vs Unpaid appointment dates.

TELEHEALTH BY SIMPLE PRACTICE / Currently $10/month

Pros:

  • The telehealth platform gives you the ability to send reminder messages with secure appointment unique links to your client.  
  • You can share your screen during session.
  • The format looks professional. 

Cons:

  • The Telehealth by Simple Practice app must be downloaded by the client.  
  • Some clients are not able to download the app on their device for various reasons.  If the client is using their cell phone for video appointments and is not tech-savvy or unable to add apps to their phone for any reason, you’ll have to use another platform for online video conferencing.  
  • I gave up SP’s telehealth option in favor of doxy.me which doesn’t require an app.
  • The client must click on the Appointment Unique Link to access each appointment. No using an old link anymore which increases security but can be a problem if the client can’t find the email reminder or is using a device without incoming email attached to it.

CUSTOMER SERVICE

Pros:

  • Help is obtained primarily via chat and email. 
  • The Help system has tutorials and a Community Forum.
  • In the Community Forum you can ask questions and get information and answers from other SP users. You can also make suggestions for improvements or vote on other customer suggestions.
  • Friendly Reps.

Cons:

  • If email and text chat hasn’t solved your problem, you might need/want to talk to someone. It can be difficult to get someone on the phone for customer support but it is possible by communicating with the person you’ve been emailing and text chatting with. There is no phone number published but they will send it to you if you ask.

GENERAL 

Pros:

  • Couples and Minor Management recently upgraded (I haven’t used this feature).
  • Billing “Ask the Biller” blog series – one example: (https://www.simplepractice.com/whats-new/insurance-payments-ask-a-biller-4/)
  • Community listserv for asking questions and getting useful information from other users.
  • Earn credit for referring others.
  • Appointment Status Reports are helpful for finding Medicare clients in particular whose manual write offs you may have missed when updating Payments. The report is inaccurate unless you’ve manually done the CO (Contractual Obligations) write offs ahead of time. 
  • Daily Agenda emails sent in the early AM and Evening Summary emails from the system are helpful. The Evening Summary email lets you double check you’ve written your notes for the day.

Cons:

  • Auto Pay has some significant glitches.
  • Learning the “back office” particulars such as how to process clients’ invoices and statements can be frustrating.  The set up is not ideal in terms of billing clients after insurance claims have been processed. You must create Invoices before creating the Statement.
  • Invoices and Statements don’t include insurance payment information. This is confusing for client and practitioner.  Invoices and Statements lack information that should be there. 
  • If a client makes a partial payment on an invoice owed, that partial payment doesn’t show up where it should (on an invoice or on your screen). Only payments in full show up and they are not listed on the invoice itself.  If the full amount of an invoice is received by the system, the invoice is magically stamped with a Paid stamp (the date, amount, and form of payment is not on the invoice).  This makes for major confusion for the client and the practitioner.  The second step (creating a statement) must then be performed to see the payment.
  • There is no documentation within the client’s chart regarding emails sent (you can find a list in the practice Reports section but not the actual emails).
  • There is no way to directly email your client within the system (e.g. “We need to change your scheduled appointment.”). The system will send only specific emails (appointment reminder messages, invite to access client portal, notification the clinician has shared document(s), notification of an invoice or statement, overdue invoice). 
  • To document any emails sent and received outside the system, you need to copy and paste it into a note (non-appointment note) in the chart. Same for secure text messaging within the system.

ON-BOARDING

Pros:

  • Uploading client records .pdf from another EHR system is fairly straightforward with the choice of uploading to individual client records or separately as a whole. It’s tedious work but it’s doable.

Cons:

  • The system for getting insurances set up is clunky and time consuming.  Before you can set up a particular insurance for electronic claim submission, you have to enter a client with that insurance.  You can’t just get set up with all panels you are on ahead of time, which could mean a delay in submitting claims and receiving payment when you do get the first client with that insurance. Office Ally and TA’s systems were much easier.
  • The tutorials for setting up your system need some updating and improvement.
  • Initial set up is not as intuitive as it could be.
  • No customer service phone number advertised. Waiting for email or chat help to get set up might be frustrating.

MOBILE APP for General Purposes (for the clinician only)

Pros:

  • For in person visits you can securely take a photo, upload, and store your client’s insurance card directly from the SimplePractice mobile app. There’s no need for a separate scanner, HIPAA-compliant software, or computer.
  • You can perform many every day practice tasks from the mobile app (scheduling, charting, secure messaging).

Cons:

  • There is no client-facing Simple Practice mobile app where the client can send secure messages, cancel/reschedule appointments, and view billing. Clients currently have to sign into their Client Portal via the website.  They often lose track of the link information in a slew of emails. A push notification alerting the client there is a secure message or an invoice to pay via a client facing app would be a vast improvement rather than depending solely on emails.

BOTTOM LINE

If you are not already familiar with billing practices, Simple Practice might be somewhat confusing until you learn the idiosyncrasies of their system in relation to the billing process. It has been totally worth the sometimes frustrating learning curve to switch over to Simple Practice for all that it offers for a reasonable price. 

Simple Practice far exceeds TherapyAppointment.com’s Legacy system in terms of options and basic operations.  TherapyAppointment’s 2.0 system looks comparable to Simple Practice but TA’s website still has a lot of old information related to their Legacy system so it’s not clear where they are at with the rollout of their new system.

Compared to TherapyNotes, which is also highly rated, Simple Practice might be much less expensive considering the only add on price is related to claims processing. 

Start your Simple Practice free month here and receive $50 off your first paid month with my discount code – I get a $50 credit, too. 😉

From the Simple Practice website

Professional Plan

Designed for the business-savvy clinician. Add additional clinicians as needed.

$59 /month

Everything in Essential, plus all this:

Custom templates

Custom appointment reminders

Online booking

Claim filing and payment reports

Secure messaging

Administrative notes

Free billers and schedulers

Add-on: Telehealth

*Add-on: Wiley Planners

*at the time of this blog post Wiley Planners was included in the $59/month price.

Featured Image by Luis Ricardo Rivera from Pixabay Modified.

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