EHR

Simple Practice EHR Pros and Cons – link for $100 discount (November 2021 only) – Regularly $50

Posted by Bonnie McKeegan, LCSW

In this (updated) blog post, I share my experience with Simple Practice Electronic Health Record (EHR) including a few comparisons to TherapyAppointment.com’s Legacy system (TA) which I used prior to Simple Practice.

UPDATE: November 2nd, 2021

For November 2021 only, Simple Practice increased the referral discount from $50 to $100 after your initial free 30 days. If you are interested in trying it out, scroll down to the link I’ve provided (If you continue with a paid subscription you and I both get a $100 credit 😉 ).

I’ve been using Simple Practice (Professional Plan) for documentation and billing since October 2019. I’ve found my way through some of the non-intuitive processes and now offer to help others get set up. I can help you with your initial setup and explain the workflow within the system. I can help you understand how to use the calendar, reminder messages, and customize your forms. If you need some help, feel free to contact me to see if what I have to offer is what you are looking for.

I still highly recommend an EHR over paper charts. Why stress out over not being caught up with notes or the quality of your notes when you can get it done more efficiently for less than the cost of one client session per month? Using an EHR is quite possibly (it is!) the best investment I’ve made in private practice.

What is your charting process? If you are using an EHR, which one are you using? Do you recommend it?

Simple Practice Review originally published October 2020 (edited November 2021)

I highly recommend simplifying your private practice by using an EHR as soon as you can afford it. If you or your clients get reimbursed for psychotherapy services, you almost can’t afford NOT to.

For the cost of less than or close to 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, money, and stress.

If you have a telehealth practice (like I do now), an electronic health record with e-signature and a truly “paperless” office is the only practical way to go. Don’t worry, you can still use paper for those clients without access or skills to access the internet and their Client Portal.

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 exclusively telehealth practice. Despite some non-intuitive workflows and idiosyncrasies that take time to figure out (and honestly are annoying), I still highly recommend Simple Practice. 

Start your free first month of Simple Practice here and receive $50 $100! (for November 2021 only) credit for your first paid month with my discount code – I get a $100 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 (which was not possible at the time I left TA.com). 

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’s platform at the time. I got tired of waiting and I am so glad I made the transition to SP before the coronavirus pandemic turned everything upside down. 

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 priority list because, uuuummmm, no, I do not want to have to give an insurance company any money back for insufficient documentation).  In addition, the ease of integrated electronic claim submission and client billing is a big time saver, not to mention the money saved doing my own billing. 

Start your free first month of Simple Practice here and receive $50 $100 (for November 2021 only) 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, sending invoices to 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.
  • Clients can “sign” their name now rather than just click the e-signature box.

Cons:   

  • There’s no notification outside the system when a client sends you a secure text message within the system. it is possible you could put the practioner SP app on your phone and set it for notifications (this is a tech thing I am not really sure about).
  • 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 for their smartphone.  My clients don’t use the secure messaging feature. It’s too inconvienent because it requires them to sign into the portal. 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). You assign the proper office to each individual client so the Place of Service prepopulates on the calendar (then on the claim form).
  • 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 November 2021).  Having access to Wiley Treatment Planner is definitely a plus for this clinician who doesn’t enjoy treatment planning.

Cons: 

  • 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 and text messages for telehealth appointments.
  • Appointment Confirmations are a new feature.
  • Using appointment reminders has definitely reduced 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 so you have to watch for it.
  • 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. CON: 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, according to complaints I’ve read.
  • 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 the 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 in order to see the payment.
  • There is no documentation within the client’s chart regarding emails sent (you can find an email 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.
  • The system saves the secure text messaging you might do with a client, but not inside their actual chart. So, you have to copy and paste them into a non-appointment chart note.

ON-BOARDING

Pros:

  • Uploading a client’s records (in .pdf form) 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 for claim submission 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 less expensive considering the only add-on price is related to claims processing. 

Start your Simple Practice free month here and receive $50 $100 (for November 2021 only) off your first paid month with my discount code – I get a $100 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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