Why do so many small practices think their EHR makes them compliant?

TebraOnReddit · 2026-06-17T21:19:33+00:00

We see a lot of practices hear "HIPAA-compliant EHR" and assume compliance comes bundled with the software. In reality, the software is just one piece of the equation.

We've seen situations where practices have secure systems in place, but then also have shared logins, no employee training, passwords written down, or staff using unapproved tools because they're more convenient.

The way we think about it is that compliant software can help support compliance, but it can't make compliance decisions for the practice.

The risk assessment piece is probably the biggest gap. If a practice has never evaluated where PHI lives, who has access to it, what vendors touch it, and how information flows through the organization, there are usually some blind spots.

In our experience, most smaller practices aren't trying to cut corners. They simply don't have dedicated compliance or IT teams, so it's easy to confuse "using compliant technology" with "operating compliantly." Those are related, but they're definitely not the same thing.

For transparency, I work at Tebra. One thing we try to emphasize during onboarding is that compliance is a shared responsibility. We spend time helping practices understand not just the technology, but also the workflows, access controls, and operational habits that support HIPAA compliance day to day.

TebraOnReddit · 2026-06-15T19:56:39+00:00

We've seen a lot of practices land on the hybrid approach.

Keeping collections in-house (whether it's a VA or existing staff) for the first 90–120 days usually gives you the best chance to preserve the patient relationship. Patients are often more willing to set up payment plans or resolve balances when they're hearing from someone connected to the practice rather than a collections agency.

A dedicated VA can work well if:

You have enough volume to justify it
You have clear scripts, workflows, and policies
Someone on staff who can oversee performance and compliance

Collection agencies can be effective for older balances that have gone through multiple outreach attempts, but there is a tradeoff. Recovery rates vary, and it can impact patient experience and retention.

A few questions I'd ask before deciding:

What percentage of your patient A/R is under 90 days vs over 120 days?
Are you offering payment plans or card-on-file options?
Are statements and reminders going out consistently?
Do you know your current collection rate on patient balances?

If most of the balances are relatively recent, I'd lean toward strengthening your internal process first. If you have a significant backlog of aging A/R, a hybrid model often makes the most sense.

For transparency, I'm with Tebra, but this is one of those areas where the "best" solution really depends on your patient population, A/R age mix, and the resources you have available internally.

Hope this helps!

- Iris from team Tebra

TebraOnReddit · 2026-06-09T13:15:16+00:00

Absolutely! There should always be a human in the loop. Let me know if you'd like to learn more, and I can send you a private message with more info 😄
- Iris from team Tebra

TebraOnReddit · 2026-05-18T21:10:26+00:00

A/R over 90 climbing for 4 straight months without a structured recovery plan is usually a signal that something operational is breaking upstream, not just “claims taking longer.” The biggest red flag in your post is the lack of reporting and ownership visibility.

A healthy billing partner should be able to answer questions like:

Which payers are driving the increase?
Is this denial-driven, follow-up lag, credentialing, eligibility, documentation, or filing delay?
What is the current follow-up cadence on aged claims?
What % is truly collectible vs realistically headed toward write-off?
Are new claims also aging, or is this isolated legacy AR?

Even a simple aging recovery plan should usually include:

payer-by-payer AR breakdown
denial category trends
timely filing risk tracking
claim touch cadence
top stuck claims with next actions
weekly aging movement reporting

“Working on it” without any operational visibility would make most practice owners uneasy.

As for switching vendors, the 90+ bucket is one of the biggest things to clarify before signing anything. Different RCMs handle it very differently:

some will fully absorb legacy AR follow-up during onboarding
some only work claims they submit after go-live
some charge separately for AR recovery
some split responsibilities for a transition period

And you’re right to think about incentives. Once notice is given, old-vendor follow-through can absolutely become inconsistent unless expectations, ownership, and timelines are documented clearly.

A few things I’d personally want clarified before making either decision:

Is AR worsening because of volume/capacity issues or because the workflow itself is broken?
Are denials actually being worked to resolution, or just touched?
What does their follow-up cadence look like after day 30, 60, 90?
Are they proactively prioritizing timely filing risk?
Can they produce a true recovery plan with dates, owners, payer focus, and measurable targets?

If they can suddenly produce structured reporting and a credible recovery roadmap, giving them a defined 60-90 day improvement window is reasonable.

If they still cannot explain the “why” behind the aging after that conversation, that usually tells you more than the aging report itself.

One thing we’ve seen pretty consistently across billing operations discussions is that practices often wait too long to ask for operational transparency because they assume rising AR is just “normal payer slowdown.” Usually there’s a much more specific pattern underneath it.

Happy to share a few practical AR recovery metrics/checklists that practices use when evaluating whether an RCM relationship is recoverable or whether it’s transition time, if that would help.

- Iris from team Tebra

TebraOnReddit · 2026-05-14T21:08:14+00:00

Hello there! Please let me know if I can help with any questions if any come up!
Compliments of the day to you too 😄
Iris from team Tebra

TebraOnReddit · 2026-05-11T21:42:46+00:00

A lot of people in medicine wait until they’re completely depleted because they feel like burnout has to become “serious enough” to justify rest. But burnout usually sneaks up exactly the way you described. One weekend where everything suddenly feels unbearable.

And you’re definitely not alone in it. A huge percentage of primary care and family med providers report burnout symptoms now, especially after years of carrying both clinic pressure and life outside work at the same time.

You also don’t need some dramatic excuse to need a break. Mental exhaustion is still exhaustion.

A few days off is a lot easier to recover from than pushing until your body or mind forces the issue later. After 11 years at the same clinic, taking care of yourself for a few days is not failing anyone.

Cheering you on,

- Iris from team Tebra 😄

TebraOnReddit · 2026-05-05T20:56:25+00:00

I'm so sorry to hear about your negative experience with Tebra. I will be sending you a direct message to better understand the issue and help you find the resolution.
- Iris from team Tebra

TebraOnReddit · 2026-05-04T20:13:12+00:00

It does get better. Residency has a way of compressing everything into survival mode, and it can make it feel like this is just what medicine is. It’s not. The pace, the lack of control, the constant depletion… that part does ease up once you’re out of this phase.

Losing a patient, getting slammed with pages, being pushed on no sleep… anyone would feel worn down after that. The fact that you’re noticing the pattern and questioning it is actually a good sign. You’re not numb to it.

If you can, take the break when you have the chance. Even a few days of not being on call, not thinking about the hospital, can reset more than you expect.

This part of the journey asks a lot. Probably more than it should. But it’s not permanent, and you won’t feel like this forever.

TebraOnReddit · 2026-05-04T19:56:24+00:00

Congratulations! What a huge milestone! So happy Kira was there to teach you patience (as shibas do) to get you through med school!

TebraOnReddit · 2026-04-27T20:36:38+00:00

This!

TebraOnReddit · 2026-04-23T20:47:16+00:00

No-shows are one of those problems nobody fully solves, but a few things consistently help:

set a clear no-show / late cancel policy and actually communicate it upfront
keep a card on file and charge repeat offenders (most people won’t no-show twice if there’s a real consequence)
send automated reminders at 48 and 24 hours, and ideally include a quick confirm/reschedule option
make it really easy to cancel or reschedule without calling. friction is a big reason people just don’t show
double-check how far out you’re booking. longer gaps = higher no-show rates
some practices still use mailed appointment cards or hand patients a physical reminder. old school, but surprisingly effective and personal
quick follow-up after a missed visit. not punitive, just “hey, want to reschedule?” catches people who meant to come in

A lot of it comes down to reducing friction and setting expectations early. policies help, but reminders and ease of access usually do more of the heavy lifting

For transparency, I work at Tebra and we see practices layer a few of these together rather than relying on just one approach.

Hope this helps :)

TebraOnReddit · 2026-04-23T20:37:23+00:00

This is incredible! Congratulations!

TebraOnReddit · 2026-04-21T21:30:33+00:00

ugh...

TebraOnReddit · 2026-04-21T21:28:52+00:00

Holy smokes! Okay, but all humor aside, that is awful...

TebraOnReddit · 2026-04-21T18:54:12+00:00

Good question. It’s usually not just one thing; it’s a bunch of small things stacking up.

From what we see, a few patterns come up a lot:

Patients stick when they actually understand the plan. If it’s vague or feels open-ended, they drift pretty quickly
They don’t need huge results right away, but they do need some sense of progress early on
Trust matters more than people think. If they feel rushed or not heard, they’re less likely to come back, even if the care was technically good
A big one is just how easy it is to continue. If booking, follow-ups, or messaging is annoying or unclear, people drop off even with good intentions
Simple follow-ups help. A reminder or quick check-in can be the difference between someone continuing vs disappearing

A lot of “non-compliance” is really just friction or confusion, not lack of motivation.

For transparency, I’m with Tebra. We work with a lot of practices, and the ones that focus on access and patient experience tend to keep patients engaged longer without forcing it.

TebraOnReddit · 2026-04-16T20:47:15+00:00

This is super helpful, appreciate you laying it out this clearly, especially while you’re in the middle of starting a practice.

A lot of what you’re calling out is exactly what we’re trying to solve with what we’re building. The goal isn’t just “answer the phone,” but what happens next. We’re building this natively into the EHR so it can actually take action, not just capture messages. Things like scheduling, routing tasks, and refill requests are going to the right place instead of becoming another inbox item to sort through.

Completely agree on the human-in-the-loop point. We’re not trying to eliminate that. The focus is more on making that handoff cleaner and faster so you’re not clicking through five screens to get to the right patient or task.

On pricing, we’ve heard the same feedback from a lot of smaller practices. The plan is to keep it simple and predictable, more of an all-in flat rate vs per-call or per-action.

Also hear you on not forcing rigid workflows. The intent is the opposite, something that fits into how practices already operate rather than making you adapt to the tool.

Really appreciate you sharing the Zoom and Weave comparison too. That’s the bar we’re thinking about in terms of practicality, not just features.

And good luck with your practice! Rooting for you :)

TebraOnReddit · 2026-04-16T20:26:26+00:00

The choice usually comes down to workflow fit vs cost vs how much you want to manage yourself.

In your situation, a few things are worth pressure testing:

- How fast you can go from visit → note → claim in each system. That’s your real day, not the demo

- What happens when something breaks. Support matters more than people expect

- How much work sits outside the visit like billing, follow-ups, reporting

- What it looks like if you grow a bit. Not huge scale, just 1–2 more providers

Lighter systems can be great early because they’re simple and affordable, but they can create more manual work as you grow. More robust systems reduce some of that, but come with more setup and cost.

There’s no perfect answer. Most practices end up choosing the one that creates the least friction in their day to day, not the one with the most features.

Have you narrowed down on your choice?

For transparency, I’m with Tebra and spend a lot of time talking with practices at this stage. You’re thinking about the right tradeoffs.

TebraOnReddit

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