About billing in TherapyNotes
TherapyNotes is practice management and EHR software for behavioral health. Its billing features cover electronic claims and ERAs, CMS-1500 paper claims, payer and patient billing settings, prior authorizations and assisted ERA payment posting. TherapyNotes uses Claim.MD as its clearinghouse, a change made after the February 2024 Change Healthcare outage. Billing access is set by staff role, such as Practice Biller.
Does SFA work with TherapyNotes?
Yes. We work inside your TherapyNotes account using user logins your practice creates, typically with the Practice Biller role. We have no partnership or integration with TherapyNotes.
What billing work does SFA handle in TherapyNotes?
We submit claims for completed notes, work Claim.MD rejections, post ERA and paper payments, appeal denials, and follow up on unpaid claims. We can also help set up payer billing settings and ERA enrollment.
How does onboarding work?
It starts with a free practice audit, where we review your billing in TherapyNotes and walk you through where revenue may be slipping. If you move forward, we sign a Business Associate Agreement, your administrator creates user accounts for our team, and we review your payer list, fee schedules and open A/R. We also review Settings > Practice Billing and your payer list, including telehealth coding overrides by payer.
Do we need to change our EHR?
No. We work inside your existing TherapyNotes setup, so there is no migration and your providers keep documenting the way they do today. Your TherapyNotes account, note templates and Claim.MD connection stay as they are.
What access does SFA need?
We need TherapyNotes staff accounts with the Practice Biller role, which gives practice-wide billing access. Your Practice Administrator assigns the role and can remove it or the account at any time.
How are claims handled?
Once an appointment and its note are complete, the claim appears on the To-Do list, and we submit it electronically through Claim.MD. Claims are reviewed against applicable billing, coding and payer-specific rules (10,000+ in our workflow) before submission to help identify preventable errors. Rejections are corrected and resubmitted, and claim history is kept in TherapyNotes.
How are payments posted?
Enrolled payers deliver ERAs directly into TherapyNotes, and we use assisted ERA posting to apply payments and adjustments. Payers not yet enrolled for ERA send paper EOBs, which we post manually and reconcile to deposits.
How are denials worked?
We sort denials by reason, such as missing authorization, eligibility, or a code or modifier issue, and correct or appeal each one. Common behavioral health problems, like exceeded visit limits or missing prior authorizations, are reported back so they can be tracked in the client's billing settings.
How does SFA Intelligence fit in?
SFA Intelligence is our AI-assisted workflow, powered by the RCM Employee platform, which we license. It works alongside TherapyNotes, reading the claim and remittance data your practice authorizes, to run eligibility checks (270/271), check coding against NCCI edits, scrub claims, categorize denials by reason, flag timely-filing risk in A/R and reconcile 835 payments to spot underpayments. Your team keeps using TherapyNotes as usual, and our billers review and own every claim decision. There is no direct integration with TherapyNotes, only the access your practice grants.
What reporting will we get?
You get monthly reporting on collections, A/R aging, denials and clean claim rate, reviewed with your named account manager. We also use TherapyNotes billing reports where your access allows. Figures are reconciled to what TherapyNotes shows, so your numbers and ours match.
What security controls apply?
We sign a BAA before any work begins, and our U.S.-based team is HIPAA trained. Staff systems use MFA, staff devices are encrypted, and we complete an annual HIPAA security risk assessment. Your practice creates our TherapyNotes accounts and can change or revoke them at any time.
What does implementation look like?
After the BAA is signed and accounts are active, we can typically begin within 24 hours of receiving system access. The first weeks focus on clearing held or rejected claims, confirming ERA enrollment with your main payers and building an A/R worklist by age and filing deadline. With TherapyNotes, we also file any missing ERA enrollments through the Clearinghouse Services section of each payer, since enrollment can take a few weeks. Your named account manager is your single point of contact throughout.
Billing tips for TherapyNotes practices
Enroll each payer for ERA
Most payers do not require enrollment for electronic claims but do require it for ERAs. In TherapyNotes, this is done per payer in the Clearinghouse Services section, and approval can take a few weeks.
Set telehealth overrides by payer
Payers differ on place of service and modifiers for telehealth psychotherapy (for example POS 02 or 10, and modifier 95). TherapyNotes lets you set telehealth coding overrides per payer, which keeps those claims consistent.
Track authorizations on the client
Store prior authorizations in each client's billing settings. Sessions billed after an authorization runs out are a common and avoidable denial.
Sources
Product names are trademarks of their owners. SFA Solutions works inside each practice's own licensed system and is not a partner of, or endorsed by, the vendor.