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Chapter 3 — Scheduling, Notes, Outcome Measures, Groups, Telehealth, AI, eRx, Portal, Messaging

Sources: help center sections Scheduling, Notes, Outcome Measures, Group Therapy, Telehealth, TherapyFuel, ePrescribe, Client Portal, Secure Messaging, Mobile.

3.1 Appointments

  • Create: Scheduling > + New, double-click a date, hover a slot and click +, or Patient > Schedule > + New.
  • Who can schedule: Scheduler, Biller, Clinician, Intern, Clinical Admin, Supervisor. Only Clinicians receive appointments.
  • Appointment Type decides which clinicians can be picked, which service codes are offered and which note template is used. Known types: Therapy Intake, Therapy Session, Psychiatry Intake, Psychiatry Session, Group Therapy, Psychological Evaluation, Consultation. Non-clinical types: Scheduled Event (one clinician or Practice-Wide), Unavailable, Extra Availability.
  • Fields: Type, Patient(s), Clinician, Location, Use TherapyNotes Telehealth, Service Code, date and time, Duration, Frequency, Appointment Alert.
  • Recurrence: one-time or recurring, with an end date or no end. Open-ended series are created 1 year ahead and extended over time. Editing a recurring appointment asks Just this date or this date and later.
  • Unavailable blocks portal booking and can cancel appointments that conflict. Extra Availability adds openings outside normal hours.
  • Actions: Cancel Appt (this one or all future), Appt Missed (then Create Note → Missed Appointment Note; a Biller can Charge Fee), Reinstate Appt, Delete (cancelled appointments only).
  • Check-in has no dedicated status; practices type "Checked In" into the Appointment Alert.
  • Calendar views: Agenda, Day, Week (Mon–Fri, with Show Weekend), Month. Set Calendar View filters by location, clinician type, payer, language, clinicians, inactive, hide missed or cancelled, and initials (John Smith → JoSm).
  • Calendar sync: one-way feed covering 30 days back and 3 months ahead, patient initials only; Reset Access invalidates the old link.

Reminders

  • Enable in Settings > Patient Appointment Reminders. Practice default options: none unless set per patient / Email / SMS / SMS + Email / Text-or-Call + Email. Each patient can override on the Info tab.
  • Email goes out 60–20 hours before the appointment (free). SMS 24–2 hours before, between 8:30 AM and 9 PM recipient time, 14¢ each. Voice call 60–2 hours before, 14¢. No reminder is sent within 1 hour of an appointment being created; email never within 2 hours of the appointment.
  • Work phones are never contacted; SMS requires a mobile number; patients reply STOP or START.

3.2 Notes

Templates

  • Psychotherapy: Intake, Treatment Plan, Progress, BIRP, DAP, SOAP, Play Therapy, Psychotherapy Note, Psychological Evaluation, Consultation, Termination.
  • Medication management: Psychiatry Intake, Treatment Plan, Psychiatry Progress, Consultation, Termination.
  • Wellness: Coaching Note.
  • Non-clinical (any user): Contact Note, Missed Appointment Note, Miscellaneous Note.
  • Library lets a practice customize progress templates starting from SOAP, DAP or BIRP.

Known fields

  • Progress: S/O/A/P or D/A/P, diagnosis, Current Mental Status, Risk Assessment, medications, Interventions Used, Frequency of Treatment, Outcome Measures section.
  • Treatment Plan: diagnosis, presenting problem, goals → objectives → interventions (with modality, frequency, estimated completion of 1–7 weeks or 1–12 months).
  • Contact Note: Method, Reason, Billing Information, Communication Details.
  • Intake fills the Treatment Plan (diagnosis and presenting problem), which fills Progress Notes (diagnoses and objectives).

Lifecycle

  1. When the appointment's time comes, a To-Do "Complete and sign the draft …" appears. Clinical notes open from about 24 hours before the appointment.
  2. Open the note from To-Do, from the appointment's Notes tab, or from Patient > Documents > Create Note.
  3. Saved but unsigned = draft, highlighted yellow, and the To-Do stays.
  4. Sign → documentation can support billing, subject to supervisory signatures and other claim validation; signing alone does not establish universal claim readiness. Supervision may require approval or co-sign, which creates a supervisor To-Do.
  5. Every save keeps a revision; Revision History shows each one. Deleting (Clinical Admin, or Practice Admin + Clinician for assigned patients) offers delete completely or revert to the previous signed revision.
  • Helpers: History > Use (copies an earlier answer), ICD-10 search, All Normal / All Not Assessed, spellcheck.
  • Export: Download, or Download Multiple to get one combined PDF; Print.

3.3 Group and couples

  • Each participant has their own chart, treatment plan and progress note.
  • Couples: either one chart with the partner as a Contact (one bill), or two charts under a Group Therapy service code (separate bills).
  • Group DAP wizard: Step 1 attendance and times → Step 2 shared group information (Data and Plan required; flows into unstarted notes) → Step 3 individual notes (attended → DAP note; missed → Missed Appointment Note). Cancelling the group marks everyone missed.

3.4 Outcome measures

  • Included: PHQ-9, GAD-7, ACE, CAGE-AID (English and Spanish), Client Feedback Form (6 questions; questions 1–3 session satisfaction, 4–6 relational wellness).
  • Assign through the portal (Share Documents > Outcome Measures > Send Document Request) or administer in the office (Administer Now).
  • Portal status: Pending Patient Submission → Needs Processing → Completed by Patient (clinician-administered measures use Completed). One question per screen; nothing is saved if the patient leaves early. The same measure can't be resent until processed.
  • Auto-scored, showing severity. Progress notes show Baseline, Most Recent and Prior results with green or orange trend arrows. A Termination note resets the baseline.

3.5 Telehealth

  • Basic (free, 2 participants) or Premium (16 participants, screen-share sound, backgrounds, captions).
  • Can start 5 hours before to 5 hours after the appointment, only if the appointment is saved, flagged telehealth and not missed or cancelled.
  • Clinician: Start Telehealth Session → camera and mic → I'm Ready. Patient joins from the portal or as a guest via the waiting room; the clinician accepts. Photo verification is on by default (photo not kept).
  • Per-payer Place of Service and modifier overrides apply to the claim.

3.6 TherapyFuel (AI) — $40/clinician/mo

  • Generate progress notes and treatment-plan goals; generated text is shaded purple with a "Generated" tag. ReFuel regenerates sections (50 uses per note).
  • Adjust Tone (minimum 20 characters): Formal, Professional, Concise or Descriptive.
  • Scribe records sessions (minimum 8 minutes); audio is deleted after transcription; the transcript is deleted when the note is signed or after 30 days.
  • Session Assist briefs the clinician from recent notes and the plan. History summaries, insurance-card reading, Generate Contact Note from a message.
  • Not available for group or couples notes.

3.7 ePrescribe (DrFirst) — $65/prescriber/mo

  • The admin enables it; each prescriber enrolls with identity proofing, plus DEA and 2FA token for controlled substances (EPCS).
  • Patient eRx tab: pharmacy, Create New Rx, favorites, allergies, active medications, history. Rx statuses: Pending, Completed, Undeliverable, Canceled. Support staff can prepare prescriptions but can't approve them.

3.8 Client portal (TherapyPortal)

  • Enable in Settings > Client Portal. Grant access with the patient's DOB and email (DOB must match exactly); caregivers get proxy access. Badges: Full Access, Proxy Access. Resend invite after 5 minutes; reset links last 24 hours; Revoke Access.
  • Features: appointment requests (to-do approve or deny), document requests (review, e-sign, upload, forms, measures), payments with saved cards, telehealth join.
  • Responses land in Process portal document responses; form data can be imported into the chart.

3.9 Secure messaging

  • Patient topics and who sees them: Admin — Schedulers, Practice Admins, assigned clinicians, Supervisors, Clinical Admins. Billing — Billers + clinical staff. Clinical — assigned clinicians, Supervisors, Clinical Admins.
  • + New Conversation → patient, topic, subject, body. A blue check means the patient has read it.
  • Deleting: anyone can delete a message the patient hasn't seen; once seen, only a Clinical Admin (Clinical topic) or Practice Admin (Admin and Billing topics) can.
  • Internal messaging is optional, with staff groups; auto-archive after 14, 30 or 60 days (default 30). Generate Contact Note turns a thread into a Contact Note.

3.10 Mobile app

  • Staff only: own agenda, messaging, patient directory, biometric login. Offline view covers 2 weeks back and 4 weeks ahead. No notes, billing or portal.

3.11 Open questions

  • Full field lists for each note template; exact sign, lock and amend rules; a complete appointment status list; outcome-measure scoring tables.

3.12 Connected clinical rebuild — October 24, 2026

  • /notes is a patient-linked workspace with 30 fictional seeded notes across the 15 patients, draft editing, author signature demonstrations, retained revision snapshots and explicit amendment starts.
  • /notes/review derives its queue from submitted notes. Staff To-Do, patient Documents and the workspace all open the same note ID. Supervisor co-sign and a return-for-correction flow are demonstrated. Return/comments are our product workflow choice, not a verified TherapyNotes UI parity claim.
  • /questionnaires assigns Client History Form, GAD-7 and PHQ-9. /portal/$requestId is a fictional one-question-at-a-time patient answer page. Final submission exposes all answers and scores immediately to /questionnaires/$requestId, patient Documents/Portal/Insights and the note editor side panel. Mark Processed records the reviewing fictional clinician and review notes; repeat requests are blocked until processing. Our compact status label is Completed, not the source product's method-specific Completed by Patient.
  • History prompts and sample clinical content are invented demonstration content. GAD-7 and PHQ-9 scoring uses established additive 0–3 responses and published bands; PHQ-9 item 9 triggers a separate safety-review flag even when the total score is low. Screening results are not diagnoses.
  • Generic library files/instruments have addressable reference pages but no invented legal forms, scoring or source PDFs. Only the three listed questionnaires can be answered.
  • Signed-note editing is inconsistent across public source articles. This build retains signed snapshots, starts a draft amendment and requires re-sign/re-review; it does not overwrite the prior signed snapshot.
  • All clinical records remain disposable fictional browser-session data, not durable clinical records, authenticated signatures or live patient portal access. No real PHI belongs in these public pages.

Official workflow sources

  • Create a Note: https://support.therapynotes.com/hc/en-us/articles/30661325329051-Create-a-Note
  • Quick Start Notes: https://support.therapynotes.com/hc/en-us/articles/30661345691419-Quick-Start-Notes
  • Supervision: https://support.therapynotes.com/hc/en-us/articles/32522534750363-Set-Up-Supervision
  • Outcome Measures: https://support.therapynotes.com/hc/en-us/articles/30661471510299-Outcome-Measures
  • Review Outcome Results: https://support.therapynotes.com/hc/en-us/articles/30661416591003-How-to-Review-Outcome-Measure-Results
  • Outcome Results in Notes: https://support.therapynotes.com/hc/en-us/articles/30661508176923-Viewing-Outcome-Measures-in-Progress-Notes
  • Signed-note source conflict: https://support.therapynotes.com/hc/en-us/articles/43400498272283-Writing-Notes-with-Progress-Note-Templates

3.13 Uploaded Quick Start Notes guide

Source: user-provided 12-page Quick Start Notes — TherapyNotes PDF, received October 24, 2026; official article linked above.

  • Settings > Interventions now supports adding, editing, deleting, Save and Add Another, and modality/frequency/completion defaults. Names follow the guide; seeded default values are fictional illustrative choices, not clinical recommendations or exact copied practice settings.
  • Signed intake diagnosis and presenting problem carry into a new treatment plan. Signed plan diagnosis and objective/intervention text carry into a progress note. Fresh encounter observations and safety assessment stay empty, requiring clinician input. Only same-patient, signed sources dated no later than the new note are used; source links remain visible.
  • Calendar appointment note creation maps therapy intake/session and psychiatry intake/session to their corresponding templates; saved appointment service code, clinician, date and ID are preserved. Reopening reuses the same note. The calendar flow enforces the guide's 24-hour availability window in local practice time.
  • Standalone chart note creation remains available without a billing service, reflecting the guide's unscheduled-note chart path. It does not assert a billable encounter. Non-clinical contact and missed-appointment template choices are now visible but detailed template-specific field parity remains incomplete.
  • Remaining gaps: enforcing saved treatment-plan age/required rules and director-signature settings, custom SOAP/DAP/BIRP template editing, full role-specific clinical access, PDF downloads/combined PDFs, appointment-derived automatic To-Do items, and durable clinical/billing storage. The uploaded guide is reference material, never an authorization to import PHI.

Uploaded guide findings (Oct 2026)

Sources: user-uploaded TherapyNotes Help Center PDFs (Play Therapy Progress Note, Client Feedback Form, Client History Form, Outcome Measures, Review Outcome Measure Results, Progress Note templates, Document Library, PCI Compliance).

  • Play Therapy Progress Note (built): DAP structure plus Materials Used and Observed Play Themes pick lists, Data, Treatment Plan Progress, Assessment, Plan; sign with "Sign this Form". Lists are admin-customizable in TherapyNotes; in HubsteriaNotes they are fixed sample lists for now.
  • Client Feedback Form (built): six questions rated Strongly Agree → Strongly Disagree; Session Satisfaction = Q1–3, Relational Wellness = Q4–6. Client picks one of up to three most recent appointments in the last 30 days; each appointment is rated once. Processed via Mark as Processed; scores are not shown in note Outcome Measures. Question wording in HubsteriaNotes is original, not copied.
  • Open: "Always Available" portal setting, Spanish version, clinician "Administer Now", PDF download, and customizable play lists. PCI guidance applies only once real card payments exist (none today).