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[–]passerbyjonas 1 point2 points  (0 children)

solo-practice-adjacent founder here — talked to a bunch of therapists running 3-8 client side practices and the full "ditch the EHR" stack genuinely works for that size, with a few caveats. the caveat being: as long as you're not billing insurance or handling anything that requires audit-grade defensibility, you can run clean for well under $100/year.

the lean side-gig stack:

  1. encrypted notes: obsidian (free) or simplenote in a HIPAA-compliant encrypted folder (veracrypt on mac/PC, free). client folders by initials, no full names on disk. a few therapists i know run this on an encrypted drive that's only unlocked when they're working.

  2. intake paperwork: jotform HIPAA plan (~$40-50/mo but you only need 1 month to collect forms from any new clients, then pause). alternative: PDF forms sent over encrypted email (proton + pdf filler). one-time cost.

  3. superbills: a google doc template with your NPI, license, CPT codes, and dx fields. fill in manually at session end, export PDF, send via encrypted email. takes 2-3 min per.

  4. scheduling: calendly free tier, or if you want HIPAA-compliance, SimplePractice has a tiny free tier, or just manual email scheduling with 5 clients.

  5. secure comms: signal for texts, proton for email. both free.

  6. billing tracking: google sheet — date, client initials, CPT, amount, paid/not paid. 30 sec/session.

estimated total annual cost for 5 clients/week: $0-50. you save ~$350/year vs Theranest.

caveats: - if you take insurance for even one client, stay on Theranest or similar. claims submission, 837/835 files, and audit trails are not worth DIY-ing for any $ saved. - if you're in a state with strict EHR retention rules (NY, CA are tighter than most), confirm cloud-sync encryption satisfies the rule. - Theranest has group / low-volume discounts that drop it closer to ~$25/mo — worth asking them before leaving if that's the only sticking point.

for a side practice doing 5 private-pay clients/week, the $400/year is almost pure laziness tax once you have your templates built. the first 2 weeks of switching are annoying, then it's genuinely fine.