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Therapy Notes - Review

Therapy Notes - Review



Ratings:   Features - 4.5   GUI/UX - 4.5   Work Flow – 4.5   Learning Curve - 4.5 
Features:   Groups - Y   Scheduling - Y   Notes - Y   E-Filing - Y   Billing - Y   Client Portal - Y
Price:   $59/mo ($30 for additional clinicians) (Some additional fees for claims filing, and appointment reminders via SMS or Phone)

HIPAA-ppropriateness **
HIPAA Compliance Possible?
Caveats: 1

Notes: 2
**What is this? HIPAA-ppropriate information is provided by Person-Centered Tech (PCT). For more details, read here.


Pros: Attractive User-Friendly Interface, Solid Support, Great Work Flow
Cons: Limited Client Portal

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

Standout Features: Work Flow, Feature Integration, & Support

TherapyNotes is a solid contender for those desiring a user-friendly, efficient system and willing to wait for a full-featured Client Portal. In May of 2016. TherapyNotes released the long-awaited auto-posting ERA features making their e-filing feature set complete. They had previously launched their initial client portal offering in March of 2015 with limited client self-scheduling options. No significant functionality has been added since then. TherapyNotes hasn't been sitting idle between these updates, however.  Just about every month they release improvements. However it does appear that their development cycle for major features has slowed significantly. 

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. TherapyNotes has also made improvements in their alert system. In addition to notifying users that notes need to be completed, they are also informed when insurance claims need to be filed, when ERAs have been received, and more. Additionally, users are now notified via email when a client schedules an appointment through the client portal. TherapyNotes has also refined their permissions structure, allowing clinicians to have limited billing permissions (like entering co-pays), without gaining access practice-wide reports and other areas.

As with all applications, there are some trade offs.  As mentioned, there is no ability to customize progress and other 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. Oddly, despite their attention to detail, there are some minor features that continue to be missing in 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 whose authorized sessions are running out. Finally,TherapyNotes charges a per transaction fee on electronic claims submission and then again on ERA posting.  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. They are not alone in charging this additional fee, though there are some systems where claims processing is free, or is only charged one time (instead of at claim submission and ERA posting).

Despite these concerns, TherapyNotes is a top contender for many practices based on their solid, user-friendly implementation, fast development cycle and responsive support.  


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.

©2016 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.

Amy Ball's picture
Submitted by Amy Ball on Wed, 06/15/2016 - 12:56

Thank you so much, Tame Your Practice for these very helpful reviews,and thank you specifically, sbrianstn for this review comparing Theranest and Therapynotes!! These are the two I am comparing as well and I very much appreciate the time it took for your to reflect your experiences with each. You probably saved me a week's worth of time doing this!!

Thanks to all who put effort towards helping others!!

Amy Ball

Rob Reinhardt's picture
Submitted by Rob Reinhardt on Wed, 06/15/2016 - 13:07

Thank you for the kind words, Amy. Always happy to hear that the reviews have been helpful!

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.

Celeste Froehlich's picture
Submitted by Celeste Froehlich on Wed, 04/29/2015 - 07:23

I am a Therapy Notes user, and I am trying to decide whether to switch from square reader to the new TN credit card processing features. After filling out the application, and reading all the forms and disclaimers, I am more confused than ever. Could you add your thoughts about the credit card processing feature to your review, Rob? And/or, could you do an article on the ethical, practical, and legal considerations of credit card processors, and especially of using a service that allows you to keep client cards on file? Thanks!

Rob Reinhardt's picture
Submitted by Rob Reinhardt on Wed, 04/29/2015 - 16:03

Hi Celeste,

That's a great idea for a blog post. It's impossible for me to fully review credit card processing features for all applications since it would require me to set up accounts with all of them. Based on feedback I've received, they all function very similarly once you get through the set up process.

There are definitely some considerations to bear in mind with keeping cards on file. My colleague and co-host of TherapyTech, Roy Huggins has written an article that covers a lot of it.

Brad Pliner's picture
Submitted by Brad Pliner on Wed, 04/29/2015 - 18:29

Hi Celeste, The numbers we keep on file in TherapyNotes are tokens that are not actually the credit card number. They only work with your merchant account. If stolen, they would be useless to a third party. We never actually store the credit card number anywhere. Having this token on file means you can charge the patient in the future without requesting the card again. Our credit card system is extremely secure, but of course it is - we are also securing medical records.

The biggest advantage over Square is the ease of use. It's fully integrated. TherapyNotes knows your patient's balance, it has their card on file, and when you charge their card it updates their records in one step.

Also, our fees are extremely competitive, and not too far off from Square.

Our customers love our credit card services. It's a very popular feature. You could even try it and keep Square in case you change your mind.

Steve's picture
Submitted by Steve on Mon, 06/08/2015 - 20:34

As a novice, I have a few "dumb" questions that I hope you can help.

In terms of submitting insurance claims through Therapy Notes, would that replace Navinet? So I would fill out all of the info on TN and the claim would be submitted to the insurance company (e.g., Highmark), right?

As for the credit card processing, what device does TN use? That is, do they provide a card reader that attaches to a phone or a more traditional swipe machine?

Rob Reinhardt's picture
Submitted by Rob Reinhardt on Mon, 06/08/2015 - 20:39

Hi Steve,
E-Filing will be similar regardless of the system you choose and will replace any other electronic claims filing system you are currently using. This assumes that the system you use is connected with every insurer in question (most of them will be).

TN supports a specific card reader that I believe you have to purchase separately. You connect it to you computer so that charges are read directly into TN. Most systems work in a similar fashion though the specific details may vary some.

Steve's picture
Submitted by Steve on Tue, 06/09/2015 - 08:08

Thank you, that was very helpful.

Brad Pliner's picture
Submitted by Brad Pliner on Tue, 06/09/2015 - 10:44

TherapyNotes would replace NaviNet for submitting claims. You would still have access to NaviNet for certain functionality if you wanted. My wife's practice was thrilled to not use NaviNet any more because the site is slow and quirky, and required a lot of double data entry. Your time savings will be immediately obvious to you.

TherapyNotes supports most any USB card readers. It connects to your Mac or PC and easily integrates with TherapyNotes. No software is required to install. We recommend a particular one on which you can buy from Amazon for about $50, simply because it's well priced and we've tested it. You can also just type in card numbers but it's worth the convenience of swiping.

Be sure to post any additional questions, but we encourage you to try the free trial and/or call TherapyNotes directly with any questions at 215-658-4550.

Tracy Kalloway's picture
Submitted by Tracy Kalloway on Sat, 06/13/2015 - 22:44

Therapy Notes informed me that my password was about to expire and needed to be changed, so I did---and then completely forgot what I had changed it to. Yes, I know I should have written it down, but I forgot to do that. I requested a password reset, and went through all the screens/hoops it requested. It was then that I discovered Therapy Notes "reviews" all requests to reset passwords, and it can take up to 48 hours to okay your new password! It's the weekend, so I'm betting I will be waiting the full 48 hours for the approval. This is unacceptable to me. I have been looking at several other programs due to TN not allowing custom note templates and the lack of a complete accounting section. Being locked out of my account when I'm trying to get caught up on notes after a busy week is the final straw.

Brad Pliner's picture
Submitted by Brad Pliner on Sun, 06/14/2015 - 10:37

I understand your frustration. But yes, we manually review all password resets. Social engineering is one of the easiest ways to break into a computer system, and security is our top priority. Protecting your password should be your top priority. Please note it doesn't take 48 hours, it takes UP TO 48 hours. We've already reached out to you.

David Toplin's picture
Submitted by David Toplin on Mon, 06/22/2015 - 15:50

Good day!
A helpful feature would be for there to be a reminder to the clinician or billing manager when a current prior-authorization period is soon to be up.


Rob Reinhardt's picture
Submitted by Rob Reinhardt on Mon, 06/22/2015 - 15:58

I completely agree that authorization tracking is a much desired and useful feature. While Brad from TherapyNotes often replies to comments here, however, I encourage you to register your request through their feature request portal at TherapyNotes as I assume it's more likely to get attention there.

Melissa's picture
Submitted by Melissa on Wed, 05/11/2016 - 14:38

There are some major issues that business owners should be aware of. While the program itself is sleek, user friendly, intuitive, and encompassing. Some major issues include accounting inaccuracies. The most costly one for business owners is that any refund issued to a client, or a redacted payment by insurance, is only reflected on the actual date of service. So if you have already paid your therapist months ago for that session, and pull an income report for this current payperiod, in which you issued the refund, you will not find it. It gets deducted, on paper, from the therapists income at the date of service, not the date it was issued. So you can't easily deduct the refund back from the therapists pay using their accounting features.

Another major issue is diffulty navigating the calendar if you are scheduling for many therapists at once. We have 12 therapist and there is no way for the system to identify regular openings on a therapists scheduled without looking at them one by one on a week view of multiple therapists on a day view but you still must scroll through week to week to make sure it is a consistent opening if you like to schedule that way. Our previous system would allow us to search slots by selecting AM, Afternoon, PM and Morning, Day, Evening and it would present all the options available like "12 upcoming slots on wed. at 9AM with Sam, for example. This one is extremely cumbersome when locating slots. We made several attempts at working with TN to resolve these issues but after over a year they are still not even in the queue. They roll out lots of little stuff but the big things don't seem to ever make the list.

If you are a serious business owner consider that these things may cost you considerable time and money in the long run.

Brad Pliner's picture
Submitted by Brad Pliner on Thu, 05/12/2016 - 08:53

I'm sorry you are not happy with TherapyNotes.

* Your review is based on a misunderstanding that we offer a means for tracking clinician payments. This is not a feature of TherapyNotes. We do offer a revenue report, which is broken down by clinician. This may be useful for your purposes, but if you refund a payment to a patient it does affect past revenue. If that is problematic for you, then do not use this feature for this purpose. In the future we would like to build a system for tracking payments to clinicians.

* TherapyNotes scheduling has a lot of features to support multiple clinicians. In your case the day view is probably ideal, in which each clinician has their own column. You can use the view options to hide clinicians that you want to hide. Take note that a larger monitor may show more columns for clinicians. We have some ideas for another view for finding openings.

I hope that you'll reconsider your negative review.

Brad Pliner's picture
Submitted by Brad Pliner on Thu, 06/16/2016 - 08:53

Thanks for the update review Rob! I just wanted to respond to "However it does appear that their development cycle for major features has slowed significantly". I wanted to make sure no one gets the wrong impression.

We have grown our team considerably, now up to 31 full-time employees, including a growing in-house development team. We continue to speed up the development process. An update that didn't have major large features is because the work on large features can span multiple releases. For example we released many small updates while we were concurrently working on the ERA payment posting feature. We have a lot in store for the future! We release a major update every 4 weeks. We also always prioritize quality over quantity. We will almost always prioritize a bug fix or an important usability improvement over adding a new feature.

Our update history is available from here:

We have so much we are excited about planned for the future, including major enhancements to the portal.

Thanks again for the updated review!

ruoff's picture
Submitted by ruoff on Sun, 10/30/2016 - 10:47

Hi Rob,
Your reviews have been a gift to me and got me going with EHRs . Thank you!
I have been using Therapy Notes very happily for a while now just for my client records. I am now transitioning from using a private billing service to doing it myself with Therapy Notes-- still learning the ropes and getting my data in order.
But... just realized something. Is EACH session billed 14 cents to submit and then another 14 cents for the ERA? That is 28 cents a session which adds up quickly. Add credit card fees on top of that and you are talking some real money. I may reconsider my subscription but transferring all my records is daunting.
I will say that I have been sampling several other practice management packages and narrowed the alternatives down to Theranest and Therasoft but I would say that for record keeping TherapyNotes is the best in terms of interface and the quality of my final product. I am trying to be patient with the client portal as I would like all my paperwork on line from the start of each new client relationship. That said, the extra fees (if I have my math right) may make that moot.

Taty's picture
Submitted by Taty on Sat, 04/01/2017 - 21:38

Hello- following up on an earlier comment, have you by chance reviewed the credit card processing service of therapy notes? Wondering how it compares to alternatives. Thank you in advance!

Rob Reinhardt's picture
Submitted by Rob Reinhardt on Sun, 04/02/2017 - 10:43

Good question, Taty. I don't pursue reviewing the various credit card processing services as that would require me setting up a merchant account with all of the EHR vendors and their partners. Based on general feedback I hear from my clients and other users of the systems is that they all work relatively the same (and well). You may want to investigate what the current fees/rates are for any system you're looking to use, though those are typically very similar as well.


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