In this (updated February/March 2022) blog post, I share my experience with the Simple Practice Electronic Health Record (EHR).
The referral discount is $100 which is credited to you when you begin your monthly paid subscription after your initial free 30 days. If you find this review helpful and are interested in trying it out, scroll down to the referral discount code link I’ve provided.
I’ve been using Simple Practice EHR for documentation and billing since October 2019. Previously, call the Professional Plan, I continue to use the Essential Plan which is now $69 per month. I’ve found my way through some of the non-intuitive processes which can be annoying at times, and overall I still appreciate what this platform has to offer.
I highly recommend using 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 (or equal to) the cost of one client session per month? With integrated billing and doing it myself, my expense for billing went from 9% of paid claims to .25cents per claim submitted using Simple Practice.
To give some perspective, here’s some math for you:
- 25 sessions x $90 paid per claim: expense to a billing agency at 9% = $202.50
- 25 sessions x .25¢ per claim: expense to Simple Practice = $6.25
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 January/February/March 2022)
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 perhaps one session’s reimbursement per month (depending on your fees), you can present your practice to clients professionally with an EHR Client Portal with all of its benefits including e-signature forms, signatures on treatment plans and other documents, and streamline your practice management to save significant time, money, and stress.
If you have a telehealth practice (like I do), an electronic health record (EHR) 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 California in March 2020.
My experience with Simple Practice comes from using it as a solo practitioner since Fall 2019 so I can’t speak to it’s benefits or downfalls for a group practice (the cost may be the biggest factor to consider). It served me well in the office pre-pandemic and continues to be excellent for my telehealth practice. Despite some non-intuitive workflows and idiosyncrasies that take time to figure out (and honestly are annoying), I still recommend Simple Practice.
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.
Regarding Office Ally (OA). If you are looking for a billing-only option (using paper charts), check out OA. If I were to drop the use of an EHR, I’d go back to OA for billing. When I took over my billing to save money and serious aggravation but was still using paper charts, I used OA and I still recommend them.
I highly recommend using an EHR for time management (high on my list of priorities) and efficiency/accuracy of charting (also high on my priority list because, uuuuhhhhhmmmm, no, I do not want 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. Did I mention the money saved doing my own billing?
Simple Practice Pros and Cons
This list is not exhaustive of all the pros and cons of Simple Practice. Some clinicians I know, really don’t like Simple Practice. Others love it, or have decided it’s the best they can find, so far. Changing EHRs is an exercise in mental patience and takes time, so be sure to look at reviews of other EHRs, then decide how you want to proceed.
These are a few notes, in no particular order, from my experience. I haven’t used all of the features, and in early 2022 the plans changed, so please look carefully at the package you choose.
- The Simple Practice Client Portal is great for getting documents electronically signed by clients, sharing .pdfs and pictures (to and from clients), secure text messaging with clients, sending invoices superbills and statesments to clients, and receiving payments from clients (Stripe is integrated for online payments – the fee is comparable to Square).
- When a client shares an uploaded document 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.
- Clients can see their scheduled appointments, documents, and payments in the portal.
- Regarding creating 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 time. It’s not 100% intuitive.
- Secure Messaging via the Client Portal can be inconvienent for the client to manage. The direct secure link is sent to the client by email when a clinician sends a message to the client. The link is time limited. If the time expires, the client has to figure out how to get into their client portal. The system has been improved, but it is still a learning curve for the client.
- There’s no client-facing app for their smartphone. For the most part, 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.
- The schedule is relatively easy to manage and you can change view to day, week, or month.
- There is an option to allow clients to request appointments online via a booking widget. (I don’t use this so I can’t report on it)
- You can create multiple offices (such as for in-office visits, home visits, telehealth, etc). You assign the proper office to each individual client so the Place of Service (10, 02, 11, etc) prepopulates on the calendar (then on the claim form).
- You can change the office for each individual appointment on the calendar. So, if you usually see someone in the office (and have assigned this to their file), but you change to a telehealth appointment for that day, then you can easily change the Place of Service on the calendar just for that day.
- You can schedule Repeat appointments (multiple repeating appointments like weekly or every 2 weeks) for a set period of time.
- You can sync the calendar with your Google calendar (and possibly other calendars) but this service is now only included in the most expensive plan (the Plus Plan at $99 per month). (I don’t use this so I can’t report on it)
- 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 or telehealth, etc). There is a color coding line on the edge of each appointment on the schedule but it is difficult to see. This means you need to memorize the color for each office type or open each appointment to see where the appointment is scheduled for.
- If you assign the Simple Practice Telehealth Office (for a secure appointment-specific link to the video platform) to your client or to a specific appointment on the calendar, it automatically assigns the Place Of Service (it was originally 02 but may have changed to 10 as of January 1st 2022) to claims. There is an icon indicating a video camera which is pretty much the only obvious office assignment.
- Here’s the catch: The automatic Place of Service with the Simple Practice Telehealth Office can be a problem. If you assign SP’s Telehealth Office so that you use SP’s video platform, but the client’s insurance requires a different POS for telehealth, (e.g., Medicare is different and remains 11 until March 2022), then you have to change the POS on each individual claim (too easily forgotten prior to submission and requires extra time/effort).
CREATING DOCUMENTS, INFORMED CONSENTS, ASSESSMENTS, TREATMENT PLANS, AND PROGRESS NOTES – this is one of the best parts of Simple Practice!
- There is a large library of documents, assessments, progress notes, informed consents, etc., that are customizable (with Essential Plan) and/or you can start with a clean slate and create new documents from your own existing documents.
- Looking up diagnosis codes is straightforward.
- The Treatment Plan has been updated to make it easier to use (relatively speaking), including getting a signature from the client.
- Treatment plan reminders give you a head’s up according to the schedule you preset.
- There are two processes to learn to create documents.
- Wiley Treatment Planner is now an extra $15 per month, if you chose the Essential Plan (as of the March 2022 change in plans). 🙁 Big downer because integrated Wiley makes it so much easier to create a comprehensive treatment plan without having to type everything from scratch.
- After you Sign the plan it is locked. You can’t edit it without unlocking it.
- There is no built in process for updating the plan properly (in particular, adding progress for each intervention, objective, and goal). You have to unlock the signed plan and edit on each line item which is labor intensive and not intuitive to figure out, at all.
- You have to unlock the plan to add goals, objectives, and interventions but dating is not flexible.
- In other words, it’s not a “living” document that can be easily modified during each session.
- Recently (as of late February) changes to the treatment plan workflow have created confusion for me (and I am persistent in figure this stuff out).
- Treatment plan workflow needs serious updating. When you juxtapose that to the increase in cost by $15 to add Wiley, things are disappointing…
REMINDER MESSAGES (voice, text, email)
- 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 the reminder email and text messages for telehealth appointments.
- You can type the exact words the Voice reminder will speak.
- Appointment Confirmations are a new feature.
- Using appointment reminders has reduced No Shows in my practice.
- You can set up individual clients to receive both a text and email reminder.
Cons – I can’t think of anything specific.
- Claim processing is optional.
- Inexpensive compared to paying a billing agency.
- Once set up, it’s fast to submit.
- You get to review the actual claim before submitting it.
- Current cost choices (no more discount packages)
- 25c per claim (first 10 are included in Essential Plan)
- ERAs (Electronic Remittance Advice) are now available for download. This was a BIG improvement.
- You can grant your biller access to deal with billing.
- The Medicare ERA (electronic remittance advice) doesn’t tell you if and where the claim was forwarded for secondary insurance processing (for comparison, Office Ally’s ERA includes all information so you can verify the secondary went to the right insurance company).
- Clinicians/billers have no direct access to the clearinghouse that SP uses (Eligible, Inc).
- 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 (but not the Medicare secondaries).
- If there is an amount owed by the client after a claim comes through, deductible or coinsurance for example, there is no specific notification process to the clinician. The information is there but it’s not obvious so you have to create your own practice management process look for it.
- If a Medicare Electronic Remittance Advice (ERA) includes only claims that were assigned to the deductibles for each client (in other words a zero payment), then there is no Payment that shows up in the usual place (tabs = Billing; Insurance; Payments). You need to go through another heading to find the information then manually enter a Zero Payment and add the details for each client. This is time consuming and frustrating. There’s no logic to it from the clinician point of view.
- 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 (tabs = Billing; Insurance; Payments) 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 (from the paper check sent to you, the other insurance company website, your bank statement – ACH, etc.), then corrected in the Payments part of the SP system.
- Appointment Status feature is difficult to follow, often innaccurate in terms of Paid vs Unpaid appointment dates, nor is it easy to correct.
- You have to pay extra to give your biller access.
TELEHEALTH BY SIMPLE PRACTICE (I am not using it, currently)
- 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 and the features have been updated recently.
- The format looks professional.
- The Essential Plan which is currently $69 (previously known as the Professional plan which was $59) now automatically includes the SP Telehealth Platform. If you use another platform like I do, you are still stuck with paying for this feature with SP.
- The Telehealth by Simple Practice client facing app must be downloaded by your 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. This is the main reason I switched back to using Doxy.me.
- You might have some clients on a different platform because they can’t get Telehealth by Simple Practice on their device (which means you need to remember what each client is using).
- 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 or text reminder or is using a device without incoming email attached to it (you must remember to send the Reminder by Text if they are using a cellphone in this case).
- 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.
- There is now an option to request a phone call in their Help request widget.
- 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.
- Online tutorials are not always updated to new workflows Simple Practice creates.
- 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 (thank you for using my link!).
- 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 for other purposes 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 in a matter of seconds that you’ve written your notes for the day.
- They offer a website landing page for your practice much like Psychology Today. It’s called Monarch.
- They update processes and features frequently (unlike Therapyapppointment.com whose updates are announced then drag on for years).
- You might have to upgrade to the most expensive plan in order to add Billers, Schedulers, Supervisors, and extra clinicians. The cost can be shocking.
- Auto Pay has some significant glitches, according to complaints I’ve read. I don’t use it. I manually send invoices and statements after I’ve created and reviewed them. PRO: It only takes a minute or two per client.
- With the least expensive (Basic) plan, you cannot customize your note templates. This is a huge disappointment because this is probably the most important part of using an EHR.
- 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 and is normally included from your medical providers.
- 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 (only on the statement). 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 and doesn’t include the content of the words you typed in the notification emails you sent).
- 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 notification emails such as appointment reminder messages, invite to access client portal, notification the clinician has shared document(s), notification of an invoice or statement, and notificatin of overdue invoice. You can modify some of the email notification messages you initiate, but, again, the system doesn’t save it for you to look at later.
- 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 do with a client, but not inside their actual chart. So, you have to copy and paste them into a non-appointment chart note.
- Some of the Reports are useless because the information is inaccurate.
- Sometimes new features like Monarch appear to be higher priority and marketed heavily to us clinicians when fixing problems that have been longstanding should be more important.
- Starting in early 2022, Simple Practice updated their plans. In doing so, the cost increased. Things like Monarch and the Telehealth by Simple Practice video platform are included on the plan that allows you to modify/customize your forms. You pay for them whether you use them or not. This has enraged many of us including me. I hope for a “grandfathering” in to soften the blow of increased cost.
- Wiley Treatment Planners now cost an extra $15/month if you chose the Essential Plan.
- You can’t carve out things you don’t need in order to save money on the Essential Plan.
- 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 all client records as a whole. It’s tedious work no matter what platform you use, but it’s doable.
- There are tutorials, videos, customer service, and a community forum to help you get through the set up and learning process.
- There’s a Help chat service available during normal business hours.
- Email requests for help are answered within a business day (my experience) and include detailed instructions with screenshots.
- The system for getting insurances set up for claim submission is clunky and time consuming (depending on the specific insurance e.g., Medicare or Medicaid). 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. A work around could be to add all the panels you are on to the fake client in the system. That way when you get a real client with that insurance, you will have gone through the clearinghouse connection process and be ready to submit immediately after seeing your real client.
- The tutorials for setting up your office need some updating.
- Initial set up is not as intuitive or as guided as it could be.
- No customer service phone number advertised. Waiting for email or chat help to get set up might be frustrating, but you can now ask to speak to someone in the Chat box.
MOBILE APP for General Purposes (for the clinician only)
- For in person visits you can securely take a photo, upload, and store your client’s insurance card directly from the SimplePractice mobile app (for the clinician only). 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).
- 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. 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.
- You can’t deal with back office things like certain billing things via the clinician app.
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 price comparable to other EHRs.
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.
TherapyNotes is also highly rated by clinicians but you will need to investigate this closely to compare cost and options.
Office Ally’s EHR 24/7 is another option to look at. I haven’t used it though, so, like TherapyNotes, I can’t comment on specifics.
Start your Simple Practice free month here and receive a $100 off your first paid month with my discount code – I get a $100 credit, too. 😉