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Therapy Notes - Review

Therapy Notes - Review

Therapy Notes

Ratings:   Features - 4   GUI/UX - 4.5   Work Flow – 4.5   Learning Curve - 4.5   Support - 5
Features:   Groups - Y   Scheduling - Y   Notes - Y   E-Filing - Y   Billing - Y   Client Portal - N
Price:   $59.95/mo ($30 for additional clinicians) (Some additional fees for claims filing, and appointment reminders via SMS or Phone)


Pros: Attractive User-Friendly Interface, Solid Support, Great Work Flow
Cons: Limited Client Portal, Fee for Electronic Claim Submission and limited ERA integration

It's a Good Choice For Practices That:  Place great importance on a well-designed, friendly interface, solid support and don't mind waiting for a more fully developed client portal or fully integrated ERAs

Standout Features: Work Flow, Feature Integration, Support & Development

Most Recent Update:  03/26/2015

Therapy Notes is a solid contender for those willing to wait for a full-featured Client Portal and/or fully Integrated ERAs.  TherapyNotes finally launched their initial client portal offering in March of 2015 with limited client self-scheduling options. They report they will be adding to these features this year.  TherapyNotes relased their "beta" version of integrated ERAs earlier in 2014, with the ERAs being displayed within the program, leaving users to manually apply them to client accounts.  It's still unknown when they will complete integration by having those insurance payments applied directly to client accounts.  To be clear, TherapyNotes hasn't been sitting idle.  Just about every month they release improvements and updates. 

What TherapyNotes does, it does incredibly well and in style.  It has one of the most polished, user-friendly GUI/UX of any of the platforms and provides incredible time savings through it's smart, intuitive, flexible work flow.  Virtually all functions for a session (Notes, Billing, Changes, Claim Filing, etc.) can be accessed directly from the Appointment itself as well as from the Client area.  It's integrated treatment plan and progress notes are a dream come true for those who want to be able to quickly complete their notes.  Making copious use of time-saving drop downs and check boxes, notes are a breeze.  This comes at the expense of not being able to customize the notes.  However, if a modified SOAP style note works for a practice, TherapyNotes will likely fit the bill.  Among the features added to TherapyNotes over the past year are integrated credit cards and the initial stages of ERA integration.

Unfortunately, there are some considerable drawbacks to TherapyNotes.  As mentioned, there is no ability to customize progress note templates.  While many templates are provided, users are unable to adjust them in any way.  This serves well to create a very clean and efficient process.  It's important, however, that you make sure the notes meet all of your needs since you won't be able to change their format.  Additionally, your note data is somewhat locked into the system.  There is currently no way to export your Notes in any format that would be usable by another system.  Your sole option for backup/migration is to save them as PDFs.  In some ways, this is not a major concern since the likelihood of being able to move notes data between any of these systems is slim; they all use a different proprietary format.  If you do, for some reason, need your notes exported in some format besides PDF, however, you won't have that option with TherapyNotes. Oddly, despite their attention to detail, there are some minor features that continue to be ignored by TherapyNotes.  For example, while it allows for tracking insurance authorizations, users must check usage manually.  There are no alerts or reports associated with authorizations so that you can readily attend to clients who require more authorizations. Similarly, there are no alerts associated with claims being rejected by the clearinghouse.  Seeing these rejections requires a regular visit to the claims page. This same issue exists with their initial implementation of the client portal, as clinicians are not alerted via email when a new appointment is added to the schedule. These are oversights that can be overcome with planning and habit, however, the program would shine so much more if it automatically alerted clinicians to situations like these.  Finally, unlike many of their competitors, TherapyNotes charges a per transaction fee on electronic claims submission.  It's a small fee (reduced from 19 cents to 14 cents in 2015), but that can add up quickly if your practice files a large number of claims each month.

Group practices that want their clinicians to enter some billing information (like co-pays) may have concerns with TherapyNotes' permission structure.  Currently, when a person is given billing permissions, they have access to all of the billing/financial data.  While it may be efficient to have clinicians entering payments made by clients, many practices will not want them to also be able to see the billing status of other clients or the practice as a whole.

Despite these significant concerns, TherapyNotes is a top contender for many practices based on their solid, user-friendly implementation, fast development cycle and responsive support.  If they can manage to fully implement integrated ERAs and expand on the Client Portal in the near future, as well as clean up some of the finer details, they will be a tough option to beat for many users.

Full List of Reviews


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Rob Reinhardt, LPCS

Rob is a Licensed Professional Counselor in private practice and
owner of Tame Your Practice, which provides comprehensive
consulting to mental health and wellness professionals.

©2015 Rob Reinhardt, LPC, PA

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Karen Midyet's picture
Submitted by Karen Midyet on Mon, 04/22/2013 - 18:22

I have been using the insurance part of therapynotes and it has been a grueling experience. I only bill insurance for Medicare. They use Emdeon to process their claims. The application process using Emdeon was wrong, causing me weeks of delays. There is no way to get EOB's electronically, so although I get money in the bank, I am clueless about what it is for, so follow up is difficult. They cannot process EOB's and that will not be happening until the summer. Overall, I am going to have to find another program for billing. I want it all together, but this is not working for me. I know that Medicare complicates things, but I told them upfront that is the only insurance I wanted to do. Just submitting electronically is not enough for me, follow up is critical.

Rob Reinhardt's picture
Submitted by Rob Reinhardt on Mon, 04/22/2013 - 21:11

Hi Karen,

Thank you for sharing your experience. TherapyNotes lack of integration of ERAs is one of their primary missing features along with a client portal. This is the first I've heard of anyone having significant long-term issues with claim filing through them. I wonder if it's only related to Medicare. Not that it makes your experience any less frustrating, of course.

Unfortunately, only a couple of these systems have integrated ERAs at this point. That looks to change greatly over the next year or so.

Karen Midyet's picture
Submitted by Karen Midyet on Sun, 04/28/2013 - 08:46

Yes, I think it is related to Medicare. But between Emdeon and TherapyNotes, somebody should know what they are doing. I hope I have educated them but I am looking further.

Rob Reinhardt's picture
Submitted by Rob Reinhardt on Sun, 04/28/2013 - 10:13

Thank you for the clarification, Karen. It's good information for everyone to know what the issue is related to. I agree that the vendors should be on top of this sort of thing.

Monika's picture
Submitted by Monika on Fri, 08/23/2013 - 02:04

I appreciate therapynotes design, and diagnostic codes drop down menu, but the billing component has turned my 50 hour work week into a 70 hour work week. Many clients are divorced, requesting separate invoices, but therapy notes does not have this option, and when working with a third party, such as a government entity, the program becomes very cumbersome. Recently, a basic Excel spreadsheet is in the forefront of my thoughts.

Rob Reinhardt's picture
Submitted by Rob Reinhardt on Fri, 08/23/2013 - 13:03

Hi Monika,

Thank you for sharing your experience! This is another great example at how difficult it is for any one of these programs to meet the needs of every unique practice. I don't know if this directly addresses your need, but I read that the latest update of TherapyNotes includes the ability to assign billing responsibility to someone other than the listed client. It sounds like that would help more for those working with parents rather than someone needing to split a bill, however.

Brad Pliner's picture
Submitted by Brad Pliner on Fri, 11/21/2014 - 12:05

Hi Rob, The patient portal continues to be our top priority. It is simply a large project and we want to get it right. We are getting very close. Our internal version now allows patients to view practice appointment availability and request appointments, and we are now working on the portion to allow the practices to confirm these appointments.

We also have a pending feature that will allow clinicians to enter copays and do basic billing tasks for their own patients. This is actually done and in testing, and will be released soon.

Just about all of your other concerns will be addressed over time. As you noted, we release major new features regularly and we are only speeding up this process as we continue to hire more developers.

Rob Reinhardt's picture
Submitted by Rob Reinhardt on Fri, 11/21/2014 - 13:35

Brad, thank you for stopping by and offering feedback on TherapyNotes. Our readers welcome the opportunity to hear directly from vendors and it sounds like you have some interesting additions coming along!

sbrianstn's picture
Submitted by sbrianstn on Wed, 01/07/2015 - 20:12

I recently started doing private practice again and have been testing out both TheraNest and TherapyNotes. I thought I’d share my experience for anyone else starting out and looking for an EHR and as such, I’ll share this review for both programs. Both programs have their pros and cons. At first glance, the user interface for TherapyNotes seems to be more polished than TheraNest. As I navigated through TheraNest over time, it did start to grow on me and there are features about it I can appreciate but out of the gate, I think TherapyNotes wins on this issue. TherapyNotes also allows you to test out electronic claims submission for free during your trial periods but then charges you 19 cents per claim afterwards. Depending on the number of your claims, this could add up over time. TheraNest does not allow for electronic billing during your trial period. If I were to subscribe with TheraNest after my trial, I would have to pay a one-time $25 connection fee to connect to my OfficeAlly account but then I could submit claims electronically without being charged additional fees. For me, I really appreciated the ability to be able to test out the electronic billing during my trial period with TherapyNotes. I have not encountered any problems thus far with the claims I have submitted. I had a few questions and concerns early on and when I emailed their support, I got a response back in no time. With TheraNest, I ran into a billing problem immediately. As I mentioned, I cannot test electronic billing so I attempted to generate a CMS1500 form. Although in every location imaginable, I had entered that my billing location was separate from my practice location, on the test form, it showed the same location for both. I emailed support and did not hear back until the following day, only to tell me they were looking into it. Two days later, I still had heard nothing so I emailed asking if there were any updates….still looking into it. I was assured that locations show up correctly on EDI files but I don’t know this as trial users are unable to test this out. When I mentioned this to the representative, I was informed that there is a 30-day money back guarantee after you subscribe if you are not satisfied. I do like the fact that TheraNest allows you to create an invoice without having to create a treatment plan or progress note ahead of time. The system will prompt you that there is no associated note but simultaneously allow you to override this and print anyway. For my practice, I am on panel with an HMO group which asks me to complete a discharge appointment with members being discharged from an inpatient facility. In this instance, a progress note would suffice. In TherapyNotes, however, you are forced to complete a treatment plan and progress note before you can do any billing activities and there is no way to override this requirement. TherapyNotes does shine with exemplary templates for those required treatment plans, progress notes, etc but with all due respect, TheraNest’s form templates are also nice. Both programs allow you to scan in external documents. Where TheraNest has an edge up is that it allows you to create your own forms whereas TherapyNotes does not. TheraNest also has TheraBook integration in place. I’ve heard that TherapyNotes is working on some type of patient portal but there is nothing in place as of yet. After your trial period is up, there is a considerable difference in monthly fees between these 2 programs. For a small start-up practice like mine, TherapyNotes rings up at $59/month and TheraNest at $29/month. In addition, with TherapyNotes, I’m going to have to start paying for that electronic billing and if I go through with ERA, that will be an additional fee as well. With TheraNest, I’ll have to pay that one-time $25 EDI setup fee but no more after that. So which will I go with? That remains to be seen. At this point, I feel like that $30 extra per month can be seen in a much more polished user interface and quick turnaround time from customer service. On the other hand, I like some of the flexibility that TheraNest gives you. I only wish I had the ability to test out the electronic claims as this is a big issue for people in private practice. Given I’ve already ran into issues out of the gate and the slow turnaround time from customer service, this is somewhat of a red flag. I think most people will stick with the program they started out with as the thought of having to put all your client info into a new program may very well keep you parked where you are.

Brad's picture
Submitted by Brad on Mon, 03/30/2015 - 10:51

sbrianstn, Thank you for taking the time to review TherapyNotes and discussing your findings here. I wanted to follow up on your review with some updates and clarifications.

TherapyNotes reduced claim pricing to 14 cents each, with no minimum and no set up fees.

OfficeAlly is NOT free if more than 50% of your claims are government OR if you send a claim to someone out of their payer network, which is much more likely than with TherapyNotes. We have a much larger payer network than OfficeAlly.

TherapyNotes recently launched a patient portal called, so patients can view your availability and schedule their own appointments. More features will continue to be added to the portal. There is no additional fee to use the portal.

If you have any additional experiences with TherapyNotes that you'd like to share, we'll continue to monitor this forum.


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