Chapter 2 — Practice, Staff, Roles, Patients, Security

Sources: TherapyNotes help center sections Getting Started, Patient Records, User Accounts and Roles, Access Your Account, Practice Information, Security, Practice Subscription (see sources.md).

2.1 App shell

Sidebar: Home, To-Do, Messages, Scheduling, Patients, Staff, Contacts, Billing, Payers, Library (items depend on role). Collapsible; becomes a dropdown on narrow screens.
Top bar: Global Search (pages and help articles), Settings, Support, Profile menu (Practice Code, Profile, Referral Rewards, TherapySearch, Log Out).
Shared UI patterns: info boxes with a pencil to edit; green Save bottom-left; blue Add top-right; warning on unsaved changes; tables with Export Spreadsheet, Save or Print as PDF, Select Columns.
Settings > Display Preferences: Light (default), Dark, OS. Saves immediately.

2.2 Roles (a user can hold several; only a Practice Administrator changes roles)

| Role | Can | Cannot | |---|---|---| | Clinician | Own calendar; clinical notes and files for assigned patients | Unassigned patients' clinical records | | Intern | Assigned clinical user; can be supervised | (full permission set not documented) | | Practice Scheduler | Every clinician's schedule; schedule and cancel appointments; add and edit patients; Missed Appointment, Contact and Misc notes | Clinical notes; own calendar unless also Clinician | | Practice Biller | All patients' billing, claims, payments, reports | Clinical notes | | Biller for Assigned Patients Only | Add-on for Clinicians: billing info, rates, insurance, copays and payments for assigned patients | Submit claims, CMS-1500, superbills, practice-wide reports | | Practice Administrator | Staff, roles, password resets, security, practice and subscription settings, Library | Clinical access or scheduling on its own | | Clinical Administrator | Must also be a Clinician. All patients and all notes; assign and unassign clinicians; only role that can delete signed notes | — | | Supervisor | Review, approve and co-sign supervisees' notes; bill under supervisor credentials if also Clinician | — |

Change roles: Staff > name > Info > Roles > Save Changes.
Non-clinical users (Admin, Scheduler, Biller, Supervisor without Clinician) are free seats.

2.3 Staff lifecycle

Staff > + New User → roles → required username, first name, last name, email → Save New User → temporary password shown (case-sensitive, contains dashes, must be changed at first login).
Clinical fields: type of clinician (decides which note templates are available), formal name, license, NPI, taxonomy (needed for Medicare and Medicaid claims).
Users are never deleted: Disable User; reactivate via Show Inactive Users > Enable User. Inactive users can't log in and aren't billed.
Work Schedule tab: + Add New Schedule (effective dates, days and times, mode and location), + Add Adjusted Availability, Work Locations, Telehealth Service States, "Patients may use the portal for scheduling with me", "Accepting new patients" (on by default). Booking outside hours warns but isn't blocked.

Supervision

Give the supervisor the Supervisor role.
Supervisee User Information > Supervision: one of Access notes and co-sign for selected payers, Must review and approve all notes, Must review and co-sign all notes; choose supervisor(s).
Approve and co-sign modes create supervisor To-Dos.
Per-payer billing override (needs Admin + Biller): Bill as Clinician, Include Clinician and Supervisor, or Bill as Supervisor (Incident-To).
Existing notes don't inherit changes; edit the note header → Update Note Header → re-sign.

2.4 Practice setup

Settings > Practice Information and Locations: name, contact info, address, website, Type 2 NPI, Tax ID, taxonomy, time zone, Account Owner. Must match payer records; PO boxes and phone extensions cause claim rejections.
Locations: + New Location with Place-of-Service code and optional "Use TherapyNotes Telehealth"; one primary location; drag to reorder. An appointment's location flows into reminders, forms and claims. Prefer per-payer Telehealth Coding Overrides over separate telehealth locations.
Welcome Message (rich text, visible to all staff; no patient info). Practice Logo appears on statements, the login page and the portal.

2.5 Patients — the start of every workflow

Create (Scheduler or Clinician)

Patients > + New Patient → Patient Comments → Patient Information → Contacts (+ New Contact) → Assigned Clinician → Save New Patient / Save and Create Another.

Only last name is required to save.
DOB is required for claims and the portal; email for the portal; full address and Administrative Sex for claims; signed HIPAA NPP acknowledgment for claims.
Preferred Name: shown to the patient and used in To-Dos, reminders and the portal; never on claims.
Gender Identity is separate from Administrative Sex. The PAD checkbox shows only for patients 18 and older.
Phones: Mobile, Home, Work, Other, each with a message preference. The reminder field appears only when reminders are enabled.
Account Number and SSN are off by default; turn on in Settings > Patient Records.
Quick add from scheduling: + New next to Patient in the appointment dialog opens a short patient form.

Assignment

Patient > Clinicians > Assign a clinician > Save Changes. A Clinical Administrator or an already-assigned clinician can assign; only a Clinical Administrator can remove.
A patient's first-ever appointment automatically assigns its clinician. Later appointments booked by a Scheduler don't.
Settings > Security > Clinician Access to Unassigned Patients: Hide (default for new practices; hides search results, demographics and contacts) or Show (demographics and self-scheduling only, never clinical records).

Status

A new patient with no appointments becomes inactive after 1 month; otherwise 4 months after the last appointment. A new appointment reactivates them.
Termination: no upcoming appointments → Documents > Create Note > Termination Note → sign.
Delete (Clinical Administrator or authorized clinician): Info > Delete Patient. Blocked if any signed notes or uploaded files exist. Intended only for duplicates.

Reminders and comments

Patient > To-Do > + New Reminder: visible to Clinicians Only or All Users; shows as a bell on the calendar.
Patient Comments: Clinician, Clinical Admin, Biller, Scheduler, Supervisor.
Billing Comments: Billers and Scheduler.
Appointment Alert: set per appointment; for recurring appointments choose Just this date or this date and later.

Files

Documents > Upload Patient File: date, name, Access = Administrative (all users) or Clinical (assigned clinicians and Clinical Admin). Max 25 MB, 150 dpi recommended, every access logged.
Special names: "Patient Photo" sets the chart photo; "Insurance Card" shows in Billing Settings; "HIPAA Agreement" and "PCP Release Consent Form" prompt updates to the related fields.

Import

Assisted import from .xlsx or VCF in 1–5 business days: demographics, account ID, SSN, billing comments, basic policies. Imported patients arrive Active and unassigned (find with Assigned to: No Assigned Clinician).

2.6 Contacts (practice-wide)

Contacts > New Contact: last name or company required. Link to patients with a relationship note; unlink all links before Disable Contact. A patient's own contact can be converted to a practice contact.

2.7 Library

Tabs: Library Files, Portal Forms, Note Templates, Outcome Measures. Questionnaires in English and Spanish, auto-scored.
Upload (Admin): Portal disabled (staff only) or enabled (shareable; patient response E-sign, Upload or none; Administrative or Clinical access). Archive hides an item; Delete is blocked while copies are shared to patients; full revision history.

Login: Practice Code + Username + Password. "Forgot practice code" looks it up by phone number or email.
Password defaults: 10+ characters with lower, upper, number and symbol; expires every 120 days; no reuse of the last 10; no name or practice code; no leading, trailing or double spaces.
2FA via an authenticator app; a browser is remembered for 30 days; renewal prompt during the last 5 days. An Admin must enroll before requiring 2FA for everyone.
IP allow-list (Admins are exempt). Inactivity timeout setting. Logging in elsewhere or a role change can end the current session.
Activity Log (Admin or Clinical Admin): filter by user, patient, action, date; maximum 3-month window per search.

2.9 Subscription (prices effective 12/1/2026 — keep configurable)

Solo $69/mo; Group $89 for the first clinician + $60 per additional clinician; non-clinical users free; 30-day trial.
Per-use: eligibility check 14¢, electronic claim 25¢, mailed claim $1, ERA 9¢ per claim, text or voice reminder 14¢, email free.
Card processing 3.1% + 30¢. Premium Telehealth $15/clinician/mo (16 participants). ePrescribe $65/prescriber/mo. TherapyFuel $40/clinician/mo.
Storage (read-only) mode: $9 for the first user + $3 per additional user. An account is terminated after 60 days of non-payment.

2.10 Open questions

The full Intern permission set; whether Schedulers can delete patients (articles conflict); exact inactivity timeout defaults.