Upheal is an EHR for therapists with insurance billing built in. You check eligibility, submit claims, and post insurance payments in the same place you write your notes, with no separate clearinghouse account and no monthly billing fee. This article is a quick checklist of what's included. For setup steps, see Getting started with insurance billing.
At a glance
Capability | Upheal | In one line |
Electronic claim submission | Yes | Professional claims (837P, the electronic CMS-1500) go out through Upheal's built-in clearinghouse connection; no separate clearinghouse account. |
Checks before you submit | Yes | Every CMS-1500 box is checked before a claim is saved or sent, and likely rejections are flagged. |
Claim status tracking | Yes | Updates on its own as the clearinghouse and payer respond, from Draft to Paid. |
Eligibility checks | Yes | Run from the client's profile; shows coverage status, copay, coinsurance, deductible, out-of-pocket maximum, and visits remaining. |
Automatic ERA payment posting | Yes | With ERA enrollment, insurance payments post and match to the claim automatically. |
Primary, secondary, and tertiary insurance | Yes | All three on the client's profile, all three billable through Upheal. |
Denials and appeals | Yes | The denial and its reason show next to the session. Upheal drafts the appeal from the client's chart. |
Prior authorizations | Yes | Stored per client with dates and visit limits; Upheal tracks status and visits used and warns on a claim without one. |
Claim corrections and resubmission | Yes | Reopen, correct, and resubmit from Upheal. A resubmitted claim isn't charged again. |
Manual payment posting from EOBs | Yes | Keep your current clearinghouse and post payments on the claim in Upheal. |
Client responsibility, expected insurance payment, and write-off | Yes | Shown for every session in the billing hub, updated when the ERA arrives. |
Client payments for the client's share | Yes | Clients pay by card in the Client Portal or from a card saved at intake; 2.9% + $0.30 per transaction, no separate payment app. |
Superbills for out-of-network clients | Yes | Created from the session's notes and diagnosis codes, sent in one click or downloaded by the client in the Client Portal. |
Billing roles for group practices | Yes | Biller and Practice Manager roles handle claims and payments for the whole practice without seeing clinical content. |
Payers | Commercial, Medicaid, and Medicare | Any payer available through Upheal's clearinghouse connection, with no exclusions. |
Availability | US practices only |
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Pricing | $0.30 per claim submission, $0.15 per eligibility check, no monthly billing fee | Included with the EHR plan. |
Yes | Upheal's billing team runs your insurance billing for 5.9% of collections, or 4.9% from $25,000 a month in insurance payments. Credentialing is available. | |
Billing help from the Upheal Assistant | Yes | Ask it to check coverage, create claims, explain a rejection, draft an appeal, or flag note problems before you bill. |
Yes | Set per provider in Billing settings; box 24J carries the colleague, while the session, note and payment stay with the provider. |