Behavioral health billing is complex, involving unique coding systems, time-based billing, and pre-authorizations. Claim denials are frequent, making efficient billing software essential. This article compares Lightning Step, TherapyNotes, and Ensora Mental Health, focusing on their features, pricing, and usability to help you choose the best fit for your practice.
| Feature | Lightning Step | TherapyNotes | Ensora Mental Health |
|---|---|---|---|
| User Rating | 4.5/5 | 4.8/5 | 4.4/5 |
| CRM Included | Yes | No | No |
| AI Tools | Yes (LIA) | Limited | Yes |
| Pricing | Custom | $59/month+ fees | $29–$89/month+ fees |
| Telehealth | Included | $15/month | $12/month (or free in Premier) |
| Compliance | HIPAA, ISO 42001 | HIPAA, HITRUST | HIPAA, HITRUST |
Choose Lightning Step for an integrated behavioral health solution, TherapyNotes for simplicity, or Ensora Mental Health for lower upfront costs.
Lightning Step is an all-in-one platform created specifically for behavioral health organizations. Unlike traditional billing software that focuses just on revenue cycle management (RCM), this platform combines EHR/EMR, CRM, and RCM into a single, integrated system. By doing so, it eliminates the hassle of switching between multiple tools, simplifying operations for behavioral health practices. Below, we explore its features, compliance measures, pricing approach, and user experience.
One standout feature of Lightning Step is its AI-powered documentation, which helps clinicians by automatically generating progress notes and treatment summaries, cutting down on paperwork. On the billing side, it offers automated eligibility verification and benefits (VOBs) checks, as well as support for ACH payments, making it easier to manage patient payments.
The platform also includes a referral management system that tracks referral sources, streamlines intake processes, and keeps communication open with referring providers. Additionally, its bed board feature provides real-time updates on capacity and admissions for inpatient and residential facilities, a useful tool for managing resources effectively.
Lightning Step goes beyond basic billing by ensuring compliance and smooth integration across its modules. It is fully HIPAA-compliant, safeguarding patient data throughout the platform. The system also integrates with Salesforce, allowing practices to use their existing CRM tools while ensuring seamless data synchronization. Moreover, its telehealth feature is directly connected to the billing system, ensuring session data is automatically captured for billing purposes.
Instead of using a one-size-fits-all pricing model, Lightning Step tailors its plans to the specific needs of each behavioral health practice. This customized approach makes it particularly appealing for smaller practices or those with fluctuating patient volumes, thanks to its per-user pricing option. The platform is built to scale, accommodating everyone from solo practitioners to large, multi-location organizations. It also includes customizable reporting tools that adapt to different organizational structures.
Lightning Step has earned positive feedback for its user-friendly design and robust functionality. It holds a 4.5/5 rating on Software Advice, based on 12 reviews. Users frequently highlight the platform’s excellent customer support and real-time analytics capabilities. However, some have mentioned that the client invoicing module could be improved for larger facilities. Additionally, its marketing analytics feature provides valuable insights, such as referral trends and patient acquisition costs, helping practices refine their marketing strategies and streamline workflows specific to behavioral health.
TherapyNotes is an electronic health record (EHR) and billing solution tailored for behavioral health practices. Unlike other platforms that bundle multiple operational tools, TherapyNotes zeroes in on making insurance claims and billing workflows more efficient. Its integrated system covers everything from electronic claims to eligibility verification and payment posting, helping practices save time and reduce administrative headaches.
TherapyNotes simplifies insurance claims processing by connecting with over 2,000 payers nationwide through its clearinghouse integration. Its Real-Time Eligibility (RTE) feature works with nearly 900 insurance providers, allowing practices to verify patient coverage instantly.
The platform also includes claim scrubbing technology, which minimizes rejections by catching errors before submission. Users can submit both primary and secondary insurance claims with a single click and track the status of claims to address rejections promptly. For insurers that don’t support electronic submissions, TherapyNotes provides a paper claims mailing service.
Beyond claims, TherapyNotes supports billing with features like integrated electronic claims, eligibility checks, and electronic remittance advice (ERA) processing. It automatically records client charges and payments and even includes options for integrated credit card processing. These tools are designed to reduce delays and keep billing workflows smooth.
TherapyNotes places a strong emphasis on security and compliance. It adheres to HIPAA standards with measures like data encryption, robust firewalls, and mandatory HIPAA training for all staff. The platform is also HITRUST certified and maintains a detailed activity log that tracks nearly every action within the system, providing a comprehensive audit trail.
"Security is our top priority, and we work hard to keep your records secure so that you have less to worry about. TherapyNotes® can help your organization maintain HIPAA compliance, fulfill insurance requirements, and stay on top of best practices in the industry."
Additional security features include two-factor authentication and customizable user roles with access controls to safeguard sensitive client records. On the integration side, TherapyNotes provides API services to connect with other healthcare systems, enabling smoother data exchange and automating billing, scheduling, and documentation workflows. It also includes a built-in, HIPAA-compliant telehealth platform for remote therapy sessions.
TherapyNotes uses a straightforward per-user, per-month pricing model that adjusts based on the size of the practice.
However, additional fees can add up. Electronic claims, Real-Time Eligibility checks, and ERA processing cost $0.14 per transaction. Credit card processing fees are 2.9% plus $0.30 per transaction, and premium telehealth services cost $15 per clinician per month. While all plans offer unlimited clients, appointments, and notes, along with a 30-day free trial, these extra charges may impact busier practices.
TherapyNotes makes onboarding easy with an intuitive interface, a comprehensive help center filled with guides and FAQs, and unlimited email and phone support during business hours. For additional guidance, the platform provides step-by-step video tutorials on its YouTube channel to help users navigate practice management.
Ensora Mental Health is an all-in-one EHR and practice management platform designed to streamline administrative tasks for behavioral health practices. It tackles a common issue in the industry, where therapists often lose over 8 hours each week to paperwork and experience revenue losses of up to 18% due to billing inefficiencies. With over 28,000 therapy practices relying on it and an 87% satisfaction rating from 1,046 reviews, Ensora has become a trusted name in mental health billing solutions.
Ensora simplifies practice management by combining billing, scheduling, and documentation in one system. Key features include automated billing, invoicing, and statement generation to optimize revenue management. The platform also supports electronic claims submission and tracking, reducing billing errors and improving cash flow. Other tools like smart scheduling, automated reminders, AI-enhanced notes, and customizable forms help practices tailor workflows to their unique needs.
For payment processing, Ensora offers secure options with a fee structure of 2.99% plus $0.30 per transaction.
"Ensora Mental Health makes the end of my session a 10 min wrap up with documentation, and the end of my day a 5 min wrap up to submit ALL billing." - Ryan Camlin, Alta Pediatrics
Next, let's explore how Ensora handles compliance and integrations.
Ensora prioritizes security and compliance, offering HITRUST certification and full HIPAA compliance. In fact, 92% of users believe the platform meets HIPAA standards. Features like encryption, role-based access controls, and audit trails ensure sensitive data is protected. The platform also supports HIPAA-compliant telehealth with encrypted video conferencing and chat options.
Ensora integrates seamlessly with tools like Google Calendar, Zoom Workplace, QuickBooks Desktop, Google Workspace, Square Point of Sale, and WileyPLUS. With 75% of users satisfied with its interoperability, the platform ensures smooth communication and data sharing between systems.
"Enterprise-grade infrastructure, Single Sign-On, multi-factor authentication, and HITRUST-certified hosting that meets HITRUST certification standards keep your organization's data locked down and compliant." - Ensora Mental Health
While Ensora offers robust compliance features, Lightning Step provides more advanced tools tailored specifically for behavioral health practices, along with smoother integrations.
Ensora uses a per-therapist pricing model with three subscription tiers:
All plans include unlimited clients, helping practices manage costs as they grow.
However, additional fees apply. For instance, the Advanced plan covers only 30 claims and eligibility checks per month, with extra claims costing $0.23 each and eligibility checks $0.25 each. Text and phone reminders are $0.10 each after the first 30 monthly allowances. Add-ons like telehealth ($12 per therapist per month, or free with Premier) and Wiley Treatment Planner ($25 per therapist per month, also free with Premier) can increase costs. There’s also an annual AMA CPT License Fee of $19.50 per therapist.
In contrast, Lightning Step offers a more straightforward, all-inclusive pricing structure without these extra charges.
Ensora earns high marks for user satisfaction, with a 4.4 out of 5 rating on Software Advice (based on 998 reviews) and 4.5 out of 5 on Choosing Therapy. Users appreciate its ease of use, comprehensive features, and responsive customer service. That said, some report a learning curve when first adopting the platform, as well as concerns about the cost of add-on features.
"Overall, I've seen a lot of areas where I've been able to save time, money, and help grow my practice with Ensora Mental Health." - Kyle M, Cardinal Hope Mental Health Counseling Services
While Ensora receives positive feedback, its user experience and support offerings don't quite match Lightning Step's specialized focus on behavioral health and dedicated customer success programs.
Here's a quick rundown of the main strengths and weaknesses of each billing software, based on the detailed evaluations discussed earlier. This comparison highlights how each platform stands out and where it may fall short.
Lightning Step is a comprehensive solution that combines EHR/EMR, CRM, and RCM capabilities, all while meeting ISO 42001 standards for AI compliance. Its specialized focus on behavioral health ensures it aligns well with industry workflows.
"LIA has transformed from a useful tool to an essential resource for every clinician at Praesum. Its adoption is now a standard part of clinician onboarding and practice: time saved, improved clinical documentation, and enhanced facility performance across the board." – Praesum Healthcare
That said, Lightning Step has a few downsides, including limited mobile app functionality, occasional workflow glitches, and less flexibility in customizing reports.
TherapyNotes stands out for its reliability, user-friendly design, and around-the-clock customer support. It provides strong billing features with a minimal learning curve. However, it lacks CRM functionality and doesn’t offer the same level of AI-powered automation as Lightning Step.
Ensora Mental Health is known for its scalable pricing and its ability to tackle common paperwork challenges. With more than 28,000 therapy practices using the platform , it has a solid foothold in the market. Yet, its pricing model includes several extra fees - $0.23 per additional claim, $0.25 per eligibility check, and $12 per therapist per month for telehealth services. Additionally, its steeper learning curve can make onboarding more challenging .
Here's a side-by-side comparison of key features across the three platforms:
| Feature | Lightning Step | TherapyNotes | Ensora Mental Health |
|---|---|---|---|
| User Rating | 4.5–4.7/5 | 4.8/5 (2,434 reviews) | 4.4/5 (998 reviews) |
| AI Assistance | LIA (saves 12.5+ hrs/month) | TherapyFuel AI | AI Notes Enhancement |
| CRM Included | Yes | No | No |
| Customer Support | Responsive | 24/7 | Not specified |
| Compliance | HIPAA, ISO 42001 | HIPAA, HITRUST | HIPAA, HITRUST |
| Mobile App | Limited functionality | Full featured | Standard |
| Pricing Structure | All-inclusive | Subscription-based | Per-therapist + add-on fees |
| Learning Curve | Moderate | Minimal | Steeper |
For practices aiming to address behavioral health billing challenges, Lightning Step offers a strong option with its AI-driven tools and tailored design for the industry.
"We chose Lightning Step because they are knowledgeable in our industry. Their services help streamline our documentation processes, increase authorizations for clients, increase revenue through billing, and our overall follow-up processes." – Into Action Recovery Center
Choosing the right billing software for your practice is crucial. Here’s a breakdown of tailored recommendations based on different practice needs.
For small to medium-sized practices, Lightning Step stands out with its integrated CRM, EMR, and RCM. This combination eliminates data silos and streamlines operations, making it a favorite for practices aiming to boost efficiency. Jay, from a Hospital & Health Care organization with 11–50 employees, shared his experience in October 2023:
"Best EMR for SUD/MH. It's incredibly intuitive. New hires pick it up quickly. The support staff are the most knowledgeable and responsive EMR team I've ever encountered."
Lightning Step also excels with customizable workflows and real-time analytics, which simplify routine tasks like appointment scheduling and billing.
For practices prioritizing simplicity, TherapyNotes is a solid choice. Known for its reliable documentation and billing features, it’s especially appealing to smaller practices that don’t need extensive customization. With high user satisfaction ratings, TherapyNotes offers a straightforward solution for those looking for ease of use.
If cost is a major factor, Ensora Mental Health might be worth exploring. It provides scalable pricing options, but practices should carefully weigh the overall costs and potential complexities of implementing the software.
Practice size plays a significant role in software selection. For multi-department practices, Lightning Step’s dashboard offers valuable oversight of cross-departmental compliance. This feature is particularly useful for ensuring operational harmony.
With 98% of reviewers emphasizing the importance of HIPAA compliance and 85% ranking medical billing capabilities as a top priority, Lightning Step’s integrated billing features make it a strong contender for behavioral health and addiction treatment centers. Its all-in-one design not only simplifies processes but also reduces long-term costs by eliminating the need for multiple software licenses.
Lightning Step stands out with its all-inclusive pricing model, eliminating hidden fees and simplifying budget management for practices. With every feature bundled under a single, upfront cost, it offers a straightforward way for behavioral health practices to plan their finances without surprises.
In contrast, TherapyNotes adopts a tiered pricing system, starting at $49/month for solo providers and $59/month for group practices. However, additional features like payment processing come with extra charges, which can significantly increase costs for larger practices. Similarly, Ensora Mental Health uses a tiered model, with prices ranging from $29 to $89 per therapist per month. But, like TherapyNotes, fees for services such as telehealth and client portals can add up, making the final cost less predictable.
Lightning Step's all-in-one pricing provides a clear and consistent financial framework, helping practices avoid unexpected expenses and making it a more straightforward and cost-efficient option compared to the layered pricing systems of TherapyNotes and Ensora.
Lightning Step’s AI tools take the hassle out of billing for behavioral health practices by automating tedious tasks like progress notes. This can save providers up to 60% of their documentation time. The platform also includes advanced analytics to spot billing denials, track reimbursement rates, and improve overall revenue cycle management.
What sets Lightning Step apart is its ability to blend AI-powered automation with practical insights. This creates a smooth, efficient solution designed specifically for the needs of behavioral health providers.
When choosing between an all-in-one platform like Lightning Step and specialized tools like TherapyNotes or Ensora Mental Health, it’s crucial to weigh factors such as integration, ease of use, and overall functionality. Lightning Step offers a unified system that combines billing, scheduling, and documentation into one platform. This setup helps practices save time and reduces the hassle of managing multiple administrative tasks.
On the other hand, specialized tools may excel in certain areas, such as providing detailed clinical documentation or offering advanced billing features. However, they often require additional software or integrations, which can lead to higher costs and more complex workflows. For behavioral health practices seeking a streamlined, all-in-one solution that simplifies daily operations and eliminates the need for juggling multiple systems, Lightning Step emerges as a practical and efficient option.
