Note: See Telehealth FAQs to find answers to commonly asked questions from clinicians, and Using Telehealth features to learn more about the various features you can use for virtual sessions. For information you can share with clients, see Getting started with Telehealth for clients.

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Preparing your practice for Telehealth

The following steps will help you prepare to begin offering Telehealth appointments.

Laws and regulations

• Most clinicians can offer Telehealth, but it’s important to learn about your local laws and regulations. These guidelines are updated often so it’s a best practice to check in regularly and stay informed.
  • Check to see whether your state has a parity law covering telemedicine by visiting the American Telemedicine Association's State Policy Center and The Center for Connected Health Policy's (CCHP).
  • Visit the Medicare Telehealth Payment Eligibility Analyzer to see what you can expect in terms of reimbursement.

Billing for Telehealth 

• If you take insurance and plan to file claims for Telehealth appointments, reach out to your insurance payers to see what their requirements are and what they cover.
  • Watch Navigating Telehealth insurance billing - Ask A Biller, presented by SimplePractice to learn more. 
  • Download our Telehealth Resources Directory PDF to find links to legal, educational, and insurance resources for Telehealth.

Prepare your office

• Identify a suitable room that's quiet, private, and free of distractions.
• To keep background noise to a minimum, close any doors and shut any windows. Consider hanging a “Do not disturb” sign on the door to avoid interruptions.
• Before each appointment, check what’s in the client’s field of vision and remove all clutter and unnecessary objects. When designing your Telehealth room, pay special attention to furniture placement, lighting, acoustics, and wall color.
  • Wall color
    • If the wall color is too light, the camera lets in less light, resulting in darkened faces. If the wall color is too dark, the camera lets in more light, making faces look washed out or too light.
    • Try to choose a flat paint color in gray or light blue to avoid any reflection off the wall.
  • Lighting
    • Make sure your light source is in front of your face, not behind you.
    • Avoid harsh lighting sources, as well as backlighting from windows or overhead lights.
  • Eye contact
    • External cameras should be mounted so that both participants are looking directly at each other during a video appointment. If the camera is placed too high above the monitor, you will appear to be looking down at the monitor rather than directly at the client.
    • It can be distracting for clients when the clinician is not consistently maintaining eye contact because they are looking at another screen or taking notes. It’s a good practice to be mindful of this and explain to clients when looking away may be necessary.
      

Check your technology

• Your device
  • Make sure you have an up-to-date PC, Mac, or tablet with a high-quality integrated camera, microphone, and speakers. Make sure your operating system and browser are on the latest version.
  • Newer devices (purchased in the last two years) will be better equipped to provide Telehealth appointments.
• Internet speed
  • Test your internet connection speed using https://www.speedtest.net/. We recommend a minimum of 10 mbps for the best quality.

Tip: If you're having trouble with a Telehealth appointment, share a screenshot of your test results from https://www.speedtest.net/ when submitting a help request so that we can better assist you.

Note:  If multiple clinicians in your practice will be holding Telehealth appointments simultaneously, we recommend working with your internet service provider to increase your internet package. For multiple clinicians, a bandwidth of at least 35 mbps, but preferably more, is recommended.

Test the process

• Before your first appointment, we recommend holding a practice Telehealth appointment. Ask a friend if you can send them a link to join an appointment and test the video platform. You’ll be much more confident and prepared for your first Telehealth appointment if you know what to expect. See the Starting a Telehealth appointment section of this guide to learn how to begin. 
  

Spread the word

• Promote Telehealth as an option for clients on your website, in your practice newsletter, via email, and on your social media page.
• If clients call to book or reschedule appointments, offer Telehealth as an alternative.
• Make sure to enable online appointment requests through SimplePractice and create Availability blocks for Telehealth so that clients will see a virtual office option when requesting appointments through the Client Portal.

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Turning Telehealth on in your account

To turn Telehealth on in your account:

• Navigate to Settings > My Practice > Locations
• Under the Telehealth section, click Turn on

Note: Telehealth is included at no additional cost on the Essential and Plus plans, and it’s available as an add-on feature on the Starter plan for an additional $15/month. If you're on the Starter plan, you can manage your subscription in Settings > Subscription Information.

Important: When you signed up for your trial account with SimplePractice, you also agreed to our Terms of Service and Business Associate Agreement. All features in our platform are covered in this agreement, including Telehealth. See Telehealth FAQs for more information. 

Turning Telehealth on in your account will create a new Video Office location in Settings > My Practice > Locations.

Note: To offer Telehealth appointments through your Client Portal and appointment-request widget for online appointment requests, you'll have to create Availability blocks for your Video Office location. See Managing your Availability to learn how to set this up.

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Creating a custom Consent for Telehealth Consultation intake form

To add a new consent document for Telehealth:

• Navigate to Settings > Client Portal > Shared Documents and Files
• Click + Consent Document

Note: For more information on customizing and adding new practice documents, see Setting up the Client Portal.

Below you can find a sample Consent for Telehealth Consultation document that you can copy and paste for your practice intake. Make sure to read through it and customize it for your own practice and local laws. You'll also find a Spanish Consentimiento Informado de Telehealth document below that.

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[INSERT NAME, ADDRESS, AND CONTACT INFORMATION FOR YOUR PRACTICE HERE]

CONSENT FOR TELEHEALTH CONSULTATION

1. I understand that my health care provider wishes me to engage in a telehealth consultation.
2. My health care provider explained to me how the videoconferencing technology that will be used to affect such a consultation will not be the same as a direct client/health care provider visit due to the fact that I will not be in the same room as my provider.
3. I understand that a telehealth consultation has potential benefits, including easier access to care and the convenience of meeting from a location of my choosing.
4. I understand there are potential risks to this technology, including interruptions, unauthorized access, and technical difficulties. I understand that my health care provider or I can discontinue the telehealth consult/visit if it is felt that the videoconferencing connections are not adequate for the situation.
5. I have had a direct conversation with my provider, during which I had the opportunity to ask questions in regard to this procedure. My questions have been answered and the risks, benefits, and any practical alternatives have been discussed with me in a language in which I understand.

CONSENT TO USE THE TELEHEALTH BY SIMPLEPRACTICE SERVICE

Telehealth by SimplePractice is the technology service we will use to conduct telehealth videoconferencing appointments. It is simple to use and there are no passwords required to log in. By signing this document, I acknowledge:

1. Telehealth by SimplePractice is NOT an Emergency Service and in the event of an emergency, I will use a phone to call 911.
2. Though my provider and I may be in direct, virtual contact through the Telehealth Service, neither SimplePractice nor the Telehealth Service provides any medical or healthcare services or advice including, but not limited to, emergency or urgent medical services.
3. The Telehealth by SimplePractice Service facilitates videoconferencing and is not responsible for the delivery of any healthcare, medical advice or care.
4. I do not assume that my provider has access to any or all of the technical information in the Telehealth by SimplePractice Service – or that such information is current, accurate or up-to-date. I will not rely on my health care provider to have any of this information in the Telehealth by SimplePractice Service.
5. To maintain confidentiality, I will not share my telehealth appointment link with anyone unauthorized to attend the appointment.

By signing this form, I certify:

• That I have read or had this form read and/or had this form explained to me.
• That I fully understand its contents including the risks and benefits of the procedure(s).
• That I have been given ample opportunity to ask questions and that any questions have been answered to my satisfaction.

BY SIGNING BELOW I AM AGREEING THAT I HAVE READ, UNDERSTOOD, AND AGREE TO THE ITEMS CONTAINED IN THIS DOCUMENT.

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Por la presente doy mi consentimiento para participar en telemedicina como parte de mi psicoterapia. Entiendo que “telemedicina” incluye la práctica de la prestación de atención médica, diagnóstico, consulta, tratamiento, transferencia de datos médicos, y educación usando medios de audio, video, o de datos interactivos. 

Entiendo que tengo los siguientes derechos con respeto a telemedicina:

(1) Tengo el derecho a retener o retirar consentimiento en cualquier momento sin afectar mi derecho a atención o tratamiento en el futuro ni arriesgar la pérdida o el retiro de los beneficios de cualquier programa a los que de otro modo tendría derecho.  

(2) Las leyes que protegen la confidencialidad de mi información médica también aplican a telemedicina. Como tal, entiendo que la información revelada por mi durante el curso de mi terapia es generalmente confidencial. Sin embargo, existen excepciones obligatorias y permisivas a la confidencialidad, incluyendo, pero no limitado a denunciar el abuso de menores, adultos mayores, adultos dependientes; expresó amenazas de violencia hacia una víctima comprobable; y adonde hago que mi estado mental o emocional se convierta en asunto de interés en un proceso legal. 

También entiendo que la difusión de cualquier imagen o información de la interacción de telemedicina a investigadores u otras entidades no ocurrirán sin mi consentimiento por escrito.  

(3) Entiendo que hay riesgos y consecuencias de telemedicina, incluyendo, pero no limitado a, la posibilidad de que, a pesar de los esfuerzos razonables de parte de mi terapeuta, que: la transmisión de mi información médica puede ser interrumpida o distorsionado por fallas técnicas; la transmisión de mi información médica puede ser interrumpida por personas no autorizadas; y/o personas no autorizados pueden tener acceso a el almacenamiento electrónico de mis datos médicos. 

Además, entiendo que servicios y la atención basado en la telemedicina pueden ser no tan completos como los servicios recibidos cara-a-cara. También entiendo que si mi terapeuta piensa que yo puedo ser mejor servido recibiendo servicios directos (cara-a-cara) y si no puedo ver a mi terapeuta en persona, seré referido a un profesional que puede brindar esos servicios en mi área. Finalmente, entiendo que existe la posibilidad de riesgos y beneficios asociado con cualquier forma de terapia, y que a pesar de los esfuerzos razonables de mi terapeuta puede ser que mi condición no mejore—incluso puede empeorar.

(4) Comprendo que existe la posibilidad de beneficios con el programa de telemedicina, pero no existe garantía alguna respecto a resultados. 

(5) Entiendo que tengo el derecho a acceder mi información médica y copias de mi registro médico acuerdo a las leyes de el estado donde recibo mis servicios.

He leído y entiendo este documento de consentimiento al ingreso de servicio de telemedicina con mi terapeuta y todas mis preguntas has sido contestadas satisfactoriamente.

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Enabling your camera and microphone access for Telehealth

Telehealth is built to run in your browser so your clients can access video appointments by simply clicking a link. There’s no need for them to download another application on their computer. However, this does mean that your browser needs to have permission to use your camera and microphone. If you or your client are not able to hear or see each other, your browser might not be allowed to use your camera or microphone.

Chrome

On a Mac

• Navigate to System Preferences > Security & Privacy > Privacy.
• Choose Camera and Microphone from the available options on the left and make sure that there is a checkmark next to Google Chrome giving it access to your camera and microphone.

On a PC

• Navigate to Start > Settings > Privacy.
• Choose Camera and Microphone from the available options and select their permissions for Allow apps to access your (camera/microphone).
• Under Choose which apps can access your (camera/microphone), turn on for Google Chrome.

Within Chrome

• Open Chrome.
• At the top right, click the three vertical dots > Settings.
• Scroll to Privacy and Security and click Site settings.
• Click Camera and Microphone.
• Make sure https://video.simplepractice.com is listed under Allow. If it's under Block, click the trashcan to the right.

Safari

• Open Safari.
• Go to Safari > Preferences > Websites.
• For both the Camera and the Microphone:
• If video.simplepractice.com has Deny next to it, change it to Allow from the dropdown menu on the right.

Firefox

On a Mac

• Navigate to System Preferences > Security & Privacy > Privacy.
• Choose the Camera and Microphone from the available options on the left and make sure that there is a checkmark next to Firefox giving it access to your camera and microphone.

On a PC

• Navigate to Start > Settings > Privacy.
• Choose Camera and Microphone from the available options and select their permissions for Allow apps to access your (camera/microphone).
• Under Choose which apps can access your (camera/microphone), turn on for Firefox.

Within Firefox

• Click on the padlock in the URL bar at the top of the browser and click Permissions.
• Next to Use the Camera and Use the Microphone choose Allow.

Edge

On a Mac

• Navigate to System Preferences > Security & Privacy > Privacy.
• Choose the Camera and Microphone from the available options on the left and make sure that there is a checkmark next to Microsoft Edge giving it access to your camera and microphone.

On a PC

• Edge automatically has access to your camera and microphone because it's the default browser for Windows devices.

Within Edge

• Click on the padlock in the URL bar at the top of the browser and make sure Camera and Microphone are set to Allow.

Tip: Once you've enabled camera and microphone access for your browser, make sure to close and reopen your browser.

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Starting a Telehealth appointment

To join a Telehealth call on a computer, you and your client can click the Telehealth appointment’s unique link.

For the clinician

• Create a new appointment and select Telehealth: Video Office as the Location

• When you're ready for the appointment, click the appointment on the Calendar
• Click Start video appointment to launch Telehealth in a new tab of your browser

• Enter your name 

• Click Join Video Appointment 

When an attendee joins or leaves a Telehealth appointment, a chime sound will play to notify you. There's no way to turn this feature off.

Note: If you’d like to change a non-Telehealth appointment to Telehealth, change the location to Video Office and click Done in the appointment flyout. Clicking Done will save this change, so that the appointment is updated properly and the client receives the video appointment link via email.

For the client

As long as reminders are enabled in a client’s profile, they’ll receive an email and/or text reminder containing the Telehealth appointment link 10 minutes before the start time. The exact time the client receives the reminder may vary based on their cell phone carrier.

Note: See How to set up appointment and time of scheduling reminders to learn more. 

When the client clicks the Telehealth appointment link, it’ll open in a new tab in their web browser. They’ll need to enter their name before clicking Join Video Appointment.

The link to join the call is unique, so it can't be bookmarked and reused for each Telehealth appointment. The link expires 30 minutes after the end of the appointment. This means that clients can't rejoin a call using the same link after that time has elapsed. If your appointment goes past the 30-minute mark, you can continue to hold the call as long as neither party gets disconnected or leaves. Please see the note below for more information about handling these situations.

Note: If your appointment goes longer than 30 minutes after the appointment end time and your client gets disconnected from the call, you can extend the duration of the Telehealth appointment on your calendar so the client can rejoin the call using the same link.

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Testing call quality

Before clicking Join Video Appointment, you can check the call quality of your connection. To do this:

• Click Test call quality

• On the flyout menu, click Get started
• Follow each step to receive a report about your connection and call quality
• Click the X in the top right corner at any time to exit

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Manually sharing a Telehealth appointment link

To manually share or resend the Telehealth appointment link to the client:

• Navigate to your Calendar homepage
• Select the appointment
• Click Share Link > Send reminder

• If the client has a contact with an email address and consent to email listed in their file, you'll have the option to send a reminder to their contact as well
  • If you don't want to send a reminder to the client's contact(s), you can uncheck the box and continue on to the next step 
• If the client is having issues receiving the email with the link, you can also click Copy link to copy the link and manually send it to them by pasting it into a separate email or Secure Message

Note: If the client's file does not indicate consent to email, you'll see the following notification, and you'll be able to click the Add email consent link to update their settings.

Manually sharing the link on mobile

You also have the option to copy or share Telehealth links through the Android mobile app. This functionality will be released in the iOS mobile app soon. To do this:

• Navigate to the Calendar homepage
• Select the appointment
• Click the link icon
• Choose Copy link if you want to copy the Telehealth link and share it with the client manually 
• Select Send reminder if you want to automatically send the client an email reminder with the Telehealth link 
  • If your client doesn't have email consent, you’ll need to go to indicate consent to email on a web browser

Note: See Getting started with the SimplePractice mobile app to learn more about using the SimplePractice mobile app. 

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Using Telehealth for multiple clients at the same time

Up to two clients can join the same Telehealth video call. Each client can join the video call through the link provided in either the email or text appointment reminder.

When Telehealth is launched on the web version or mobile app, each participant will need to enter their name. After entering their name, they'll be able to click Join Video Call and begin the appointment. 

On the web version, you'll see the participant on the center of the screen, and yourself in the upper right corner:

On the mobile app, you'll see the participant on the center of the screen, and yourself on the bottom right corner:

To schedule a Telehealth appointment for two clients, you can create a couples appointment on the Calendar. If both clients have email reminders enabled, they’ll each receive a link to join the call through their appointment reminder sent about 10 minutes prior to the start of the Telehealth appointment.

If your clients don’t have email reminders enabled, you can also choose to manually send the video appointment link to each member of the couple by copying it from the appointment on the calendar. To do this:

• Navigate to the calendar
• Select the appointment
• Click Share Link > Copy link

• Paste the link into a separate email or Secure Message to manually send it to them

Note: See Enhanced Client Management for Couples to learn more about creating Couple Profiles and scheduling couple appointments.

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Using Telehealth on a mobile device

You and your clients have the option to download the Telehealth by SimplePractice mobile app to join the video call from a smartphone or tablet. You can download it here:

• For iOS
• For Android

Tip: Clients can also access Telehealth appointments directly from the SimplePractice Client Portal mobile app for iOS. To learn more, see The SimplePractice Client Portal mobile app. 

Note: While you can hold Telehealth calls using mobile data, we recommend using WiFi instead since it provides a more reliable connection. The quality of Telehealth calls on mobile data can fluctuate highly depending on your geographical location. We estimate that the data used on a Telehealth session will be between 2-20 MB/minute, though this can vary depending on your reception and internet speeds.

To join a Telehealth call, follow these steps:

• Open your SimplePractice mobile app 
• Click Schedule and select your appointment 
• Click Start video appointment
• The Telehealth by SimplePractice app will launch automatically 
  
  • The first time you launch the Telehealth app, you'll see a Welcome screen that will give you some tips on how to best optimize your Telehealth experience
  • Swipe or tap Next to go through the helpful tips
  • If you'd like to skip these tips and go straight to your Telehealth appointment, click Skip

 

• Enter your unique video appointment link and click Continue

• You'll be taken to a preview mode where you can preview your camera, turn your camera on or off, mute or unmute yourself, and view your connection status
  • Note: If you try to join the appointment without entering your name, you'll get an error message
• Enter your name, and click Join Appointment Now

• You can enter your appointment via landscape mode by flipping your device if you'd prefer 

• Once you've entered your call, you can access your call settings by clicking the three dots on the top-right of your call screen

• In these settings, you can view the number of participants in your call, flip your camera, hide self view, and view your speaker settings

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Getting your clients ready for Telehealth

Here are some common questions clients may ask, along with recommended responses:

Client questions	Recommended responses
What is Telehealth?	“Telehealth allows us to meet through audio and video over the internet.”
How does Telehealth work?	"You’ll be sent a link for the video appointment. Click on it when our appointment is scheduled to start or open it through the Telehealth by SimplePractice app (which you can download for free in the app store). You can use the camera and audio on your computer or mobile device.”
How much will it cost?	"Your cost for a video appointment will vary depending on the coverage you have with your insurance provider. Most insurances charge a copayment just like traditional appointments, and it most likely will be the same amount. We can determine your exact coverage and what your copay will be before we schedule an appointment.”

Tip: You can send your clients the client-facing guide to Getting started with Telehealth for more answers to commonly asked questions.

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Additional tips for success

• We recommend joining the video appointment 5-10 minutes before the scheduled time so you can make sure that everything is set up correctly. 
• Restart your computer every day for it to run as efficiently as possible.
• Close any unnecessary programs and applications on your computer before joining a Telehealth call. These take away from resources needed for your computer to run efficiently.
• Keep your software and operating system up to date. Install recommended updates only from sources you trust.
• You may need to adjust the volume or mute/unmute your speakers to prepare for the call. We also recommend keeping a pair of headphones nearby in case you need to use them for improved audio/voice.
• Clients might need to cancel or have questions about the appointment before the start time, so make sure you are actively checking your email and phone.
• When your video camera is turned on, there’s more strain on your internet connection which can impact the audio quality during a Telehealth call. If your audio becomes choppy, your connection or your client's may not be strong enough to support a live video stream. Turning off your camera, or asking your client to turn off theirs, may help to improve the audio quality of the call.