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 during 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.

Review laws and regulations

While most clinicians can offer Telehealth, it’s important to learn about your local laws and regulations. Because these guidelines are updated often, it’s a best practice to check them regularly and stay informed.

We recommend that you: 

• • Check 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

Understand billing for Telehealth 

If you plan to bill insurance for Telehealth appointments, reach out to your insurance payers to determine what their requirements are and what they cover. To learn more, see Navigating Telehealth insurance billing - Ask A Biller, presented by SimplePractice. 

You can also download our Telehealth Resources Directory to find links to legal, educational, and insurance resources for Telehealth.

Prepare your environment

To prepare your environment for successful video appointments:

• Identify a place 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 any doors to avoid interruptions.
• Before each appointment, check what’s in the client’s field of vision and remove clutter and unnecessary objects. 
• When designing your Telehealth room, pay 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.
    • If you can, 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’ll appear to be looking down at the monitor instead of directly at the client.
    • It can be distracting for clients when the clinician doesn't maintain eye contact because they’re 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

When you start to offer Telehealth appointments, it’s important to check your technology before your first appointment. To do this:

• Your device
  • Make sure you have an up-to-date computer or mobile device with a high-quality camera, microphone, and speakers
    • Newer devices (purchased in the last two years) will be better equipped for Telehealth
  • Make sure your operating system and browser are on the latest version
• Internet speed
  • Test your internet connection using a Speed Test
    • We recommend a minimum of 10 mbps for the best quality
      

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. See Starting a Telehealth appointment to learn how to begin.

Spread the word

You may have clients who aren’t familiar with Telehealth. To help with Telehealth adoption from your clients, you can:

• Promote Telehealth as an option for clients on your website, social media, in your practice newsletter, or via email
• If clients call to request or reschedule appointments, offer Telehealth as an alternative
• Enable online appointment requests through SimplePractice and create availability blocks for Telehealth so that clients will see a virtual office option in the Client Portal
  • For answers to questions they may have, you can direct clients to our Getting started with Telehealth guide for clients

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Turning Telehealth off in your account

Telehealth is included on all 3 subscription plans at no additional cost. Turning Telehealth off will remove the Video Office location from your account. To do this:

• Navigate to Settings > Practice > Practice details
• Under Telehealth, click Turn off

• Click Turn off Telehealth

Note: You can also customize the Video Office location to fit your practice needs by clicking Edit. 

To re-enable Telehealth:

• Navigate to Settings > Practice > Practice details
• Under Telehealth, click Turn on

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 by this agreement, including Telehealth. See Telehealth FAQs for more information.

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Creating a custom Consent for Telehealth Consultation form

To add a new consent document for Telehealth:

• Navigate to Settings > Documentation > Intake documents
• Click + New consent form

Note: For more information, see Customizing and adding new practice documents.

Below, you’ll find a sample Consent for Telehealth Consultation document you can copy and paste for your practice intake. Please read through the document and customize it for your own practice and local laws. You'll also find a Spanish Consentimiento Informado de Telehealth document.

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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 del 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 camera and microphone access for Telehealth

Clients aren't required to install any applications on their computers when using Telehealth, as it seamlessly operates in their web browsers. However, devices and browsers need permission to access the camera and microphone. If you or your client can’t see or hear each other, it’s likely that the browser doesn’t have the required permissions enabled.

Note: Anytime you enable camera or microphone access within a browser, we recommend that you close and reopen the browser to save those changes.

Chrome

On a Mac

• Navigate to System Settings > Privacy & Security
• Choose Microphone and make sure Google Chrome is toggled On

• Return to Privacy & Security
• Choose Camera and make sure Google Chrome is toggled On

On a PC

• Navigate to Start > Settings > Privacy
• Select Camera and Microphone from the available options within App Permissions on the left panel 
• Under Allow apps to access your (camera/microphone), turn the toggle On
• Under Allow desktop apps to access your (camera/microphone), turn the toggle On and check to see if Google Chrome is listed

Within Chrome

• Open Chrome
• At the top right, click the three vertical dots > Settings
• Click Privacy and security > Site settings
• Click Camera and Microphone
  • Make sure https://video.simplepractice.com is listed under Allowed to use your camera and Allowed to use your microphone

• • If it's under Not allowed to use your camera or Not allowed to use your microphone, click the trashcan icon to the right

Safari

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

Firefox

On a Mac

• Navigate to System Settings > Privacy & Security
• Choose Camera and Microphone from the list of available options and make sure the toggle to the right of Firefox is On

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), toggle Firefox On

Within Firefox

• Click the three vertical dots
• Choose Settings > Privacy & Security 
• Scroll down to the Permissions section
• Click Settings beside Camera and Microphone
  • If https://video.simplepractice.com has Block next to it, change it to Allow from the dropdown menu

Edge

On a Mac

• Navigate to System Settings > Privacy & Security
• Choose Camera and Microphone from the list of available options and make sure the toggle to the right of Edge is On

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

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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 to start the appointment, select the appointment from your calendar
• Click Start video appointment to launch Telehealth in a new browser tab

• Enter your name 

• Click Start 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 sound 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. To learn more, see Adding and managing appointments.

For the client

As long as reminders are enabled for a client, 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: To learn more, see How to set up appointment and time of scheduling reminders.

When the client selects the Telehealth appointment link, it’ll open in a new tab in their web browser (if they’re on a computer) or in the Telehealth by SimplePractice mobile app (if they’re on a mobile device). They’ll need to enter their name in order to join the call.

Tip: For step-by-step instructions you can share with clients, see Joining a Telehealth appointment from a computer and Joining a Telehealth appointment from a smartphone or tablet.

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.

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. This allows the client to rejoin the call using the same link.

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Testing call quality

Before clicking Start video appointment, you can check the 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

Tip: If you're having trouble with a Telehealth appointment, share a screenshot of your Speed Test results when submitting a help request so that we can better assist you.

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Manually sharing a Telehealth appointment link

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

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

If the client has a contact with an email address or phone number with email or text reminders enabled, you can choose to manually send a reminder to their contact. If you don't want to send reminders to the client's contact(s), you can disable this. To do this:

• • Navigate to the client Overview page > Edit
  • Click Contacts
  • Select the Manage > Edit Appointment Reminders
  • Deselect the reminder types you'd like to stop sending
  • Click Save   

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 a client hasn’t consented to email or phone notifications, you can click Add consent to update their settings.

Manually sharing a Telehealth link on the clinician app

You have the option to copy or share Telehealth links on the SimplePractice mobile app. To do this:

• Open the SimplePractice mobile app
• Select the appointment from your calendar
• Tap 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 on file, you can update this on the mobile app
    • For more information, see Navigating the client’s Overview page on the iOS mobile app or Navigating the client’s Overview page on the SimplePractice for Clinicians app

Note:  To learn more about each version of the app, see Getting started with the SimplePractice Clinician app on iPhone and iPad and Getting started with the SimplePractice for Clinicians app.

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Using Telehealth for multiple clients at the same time

If you have multiple clients in a couple or group appointment, these clients can simultaneously join a Telehealth video call with you.

A Telehealth call can have up to 15 clients at once, which is the maximum number of clients for a group appointment. We recommend that all clients have a steady internet connection to avoid any possible issues.

Telehealth is included for couple appointments in the Essential and Plus plans, and can be enabled for group appointments on the Plus plan as an add-on. For more information, see Can I use Telehealth for group appointments?

The calendar flyout for a group Telehealth appointment will have a link to Join video appointment:

Each participant will be able to join via the Telehealth link from their appointment email or text reminder. When the call launches, they’ll first need to enter their name before continuing.

Tip: Like individual Telehealth appointments, you can also click Share Link to copy the group Telehealth link or manually send it via reminder.

If you have the waiting room enabled, you’ll be able to see which clients are ready to be admitted into the call. You’ll also have the ability to decline a client from joining, or move a client in the call back to the waiting room.

Note: If the waiting room isn’t enabled, clients will be able to join as soon as they enter their name.

On the browser version, you'll see the person speaking on the center of the screen, with you and the other participants in the right column.

On the mobile app, you can use the Speaker or Grid view. In Speaker view, you’ll see the person speaking in the center of the screen, and the other participants at the bottom:

In Grid view, you’ll be able to see yourself and up to three other people at once on the screen:

Tip: If more than three people are with you on a call, click the arrow on the right side to view other participants.

All participants will also be able to chat, share their screen, and collaborate on a whiteboard. To learn more about these features, see Using Telehealth features.

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Using Telehealth on a mobile device

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 the video call from a smartphone or tablet, you and your clients can download the Telehealth by SimplePractice mobile app. You can download it here:

• For iOS
• For Android

Tip: Clients can also join Telehealth appointments directly from the SimplePractice Client Portal mobile app. For a guide that you can share with clients, see Joining a Telehealth appointment from a smartphone or tablet.

To join a Telehealth call:

• Open the SimplePractice mobile app 
  • This is different from the Telehealth by SimplePractice mobile app, which must be downloaded separately
• Select the appointment
• Tap Start video appointment

Important: If you haven’t yet downloaded the Telehealth by SimplePractice app, you’ll be prompted to do so first. After you download and open the Telehealth by SimplePractice app, you can return to the SimplePractice for Clinicians app to start the appointment.

• • The Telehealth by SimplePractice app will launch
    • The first time you use the Telehealth by SimplePractice app, you'll be prompted to choose I am a Clinician or I am a Client
    • Swipe or tap Next to review our tips for optimizing your Telehealth experience
      • If you'd like to skip these tips, click Skip
• 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
• Enter your name and tap Start video appointment

• • If you try to join the appointment without entering your name, you'll receive an error message
• Once you've entered your call, you can access your call settings by clicking the gear icon in the top right of your call screen
  • From your call settings, you can view the number of participants in your call, flip your camera, hide self view, and view your speaker settings
  • For more information about the features available when using the app, see Features on a web browser vs. the mobile app

Note: You can start Telehealth appointments directly from the Telehealth by SimplePractice app. To do this, you’ll need to copy the link for the appointment from the web version of SimplePractice or the SimplePractice mobile app, and paste it into the Telehealth by SimplePractice app.

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Getting your clients ready for Telehealth

Clients may have questions about Telehealth appointments. Here are some common questions clients might 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: For more answers to commonly asked questions, you can send your clients our Getting started with Telehealth guide for clients.

Here are some additional tips that can set you and your clients up for success:

• Join 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.