Luminello shutting down. Alternatives?

[calvnandhobbs68]

I'm thinking about switching to Sessions, but am worried about the lack of e-prescribing... for some reason, that extra step of having a separate e-rx account feels daunting and like a setup for things falling through the cracks (what cracks though? are there even cracks?)

Do y'all know what services folks use for just e-prescribing?

I have this old ass software that I use for EMR that the group uses and have my own standalone prescribing software. iPrescribe, only issue is that if you don't have a M processor Macbook, it only runs on iphones/ipads. If you have a M processor mac, you can run the software on your computer.

It's annoying, you have to manually load every new patient into the system so you're doubling work a little bit at the beginning but I've used it for 3 years without an issue besides that.

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[psycho-matic]

Anyone used TherapyNotes? They have e-prescribing now. It looks pretty appealing.

 

[clausewitz2]

I have this old ass software that I use for EMR that the group uses and have my own standalone prescribing software. iPrescribe, only issue is that if you don't have a M processor Macbook, it only runs on iphones/ipads. If you have a M processor mac, you can run the software on your computer.

It's annoying, you have to manually load every new patient into the system so you're doubling work a little bit at the beginning but I've used it for 3 years without an issue besides that.

Should note for iprescribe that if you have an Android phone you can totally run the software on a desktop in an emulator.

 

[clozareal]

I asked the question about e-ex. Apparently simple practice will have epcs integrated into their system. It's actually a very good EMR for psych. Now that they will have e-ex, I think it will be great.

I was interested in Osmind but they don't have self scheduling yet.

They do have self scheduling and two way Google calendar sync.

Osmind is pretty great. I just did the demo with them and they have a lot of functionality built out for psychiatrists. The price includes Zoom calendar integration so you can cancel your Zoom subscription if you have it, eRx, eLabs, DEA charge, and third party merchant fees.

Luminello was $149/mo + $1.55/mo for the AMA CPT code license + $4.99 for text reminders + $10/mo for PCI compliance fee + $3.75 tokeniztion fee + $15.99 for Zoom (I needed to have group meetings for families and screen share for psychoeducation slides) = $185.28/mo.

Osmind with the 35% annual discount comes out to $174.85/mo for the first year without any additional fees outside of merchant service payment fees of 2.9% + 0.30c/transaction through Stripe which is standard.

They're waiving the transfer fee and have a dedicated team to help you transfer your patient's demographic information, notes, and document/files. They're not transferring anything that SimplePractice isn't transferring, except for future appointments and DrFirst e-prescribing.

 

[psycho-matic]

They do have self scheduling and two way Google calendar sync.

Osmind is pretty great. I just did the demo with them and they have a lot of functionality built out for psychiatrists. The price includes Zoom calendar integration so you can cancel your Zoom subscription if you have it, eRx, eLabs, DEA charge, and third party merchant fees.

Luminello was $149/mo + $1.55/mo for the AMA CPT code license + $4.99 for text reminders + $10/mo for PCI compliance fee + $3.75 tokeniztion fee + $15.99 for Zoom (I needed to have group meetings for families and screen share for psychoeducation slides) = $185.28/mo.

Osmind with the 35% annual discount comes out to $174.85/mo for the first year without any additional fees outside of merchant service payment fees of 2.9% + 0.30c/transaction through Stripe which is standard.

They're waiving the transfer fee and have a dedicated team to help you transfer your patient's demographic information, notes, and document/files. They're not transferring anything that SimplePractice isn't transferring, except for future appointments and DrFirst e-prescribing.

They don't have self scheduling tough, right?

 

[clozareal]

They don't have self scheduling tough, right?

Osmind does have self-scheduling. I just wrote it in the reply above.

 

[psycho-matic]

Osmind does have self-scheduling. I just wrote it in the reply above.

I thought your first sentence was about responding to my question about TherapyNotes. Anyway, the Osmind website says it's coming in 2024. I didn't know they already had the feature.

 

[Stagg737]

This whole thread just makes me feel like paper charts with a bunch of checkboxes with a brief formulation/plan + a separate e-prescribing system and scheduling software would just be easier. Especially for small or part-time clinics.

 

[Sushirolls]

I've been have those thoughts re-surge too.
But coming back to integrated billing with clearing house and ultimate "what's left" to send to patient really saves time.
allowing patients to access calendar and reschedule or change appointemnts themselves is so nice. Saves time.

If a cash therapist, than yeah, do paper charts.

But insurance based circles back to those 2 key features for saving time.

 

[clozareal]

I've been have those thoughts re-surge too.
But coming back to integrated billing with clearing house and ultimate "what's left" to send to patient really saves time.
allowing patients to access calendar and reschedule or change appointemnts themselves is so nice. Saves time.

If a cash therapist, than yeah, do paper charts.

But insurance based circles back to those 2 key features for saving time.

I wonder about this too. Everything can be self-contained in Google Suite: you have Google Meet for telehealth, Google Docs for notes, Google Calendar (patients can even self-schedule) for appointments, and Google Voice for calls. Then you can contract with Stripe vs Square vs Stax vs IvyPay vs ACH vs Zelle or whatever for billing which might be cheaper than the 2.9-3.15% + $0.30c/transaction. You would need Office Ally or something as a clearinghouse though if you take insurance but that might not be too difficult.

Piecemeal probably makes it the most customizable and cheapest but probably also the most cumbersome. I'm willing paying $200-300/mo for an EHR that saves me time and energy, but the quality has to be there to provide me more value.

 

[Bartelby]

I think as tempting as paper charts sounds it's hard to go back. You lose:

-Instant creation of superbills
-Automated tracking of invoices and payments
-A HIPAA-compliant messaging portal
-Secure transmission of intake forms or rating scales
-Secure inquiries from new patients (linked to a website)
-A fully digital "in the cloud" practice with no need for physical storage space and no safety concerns about physical records
-Ability to access your full EMR from anywhere, including while away on vacation
-The guarantee that your patient-related systems are all HIPAA-compliant / under an existing BAA

Like clozareal mentioned above, while you could put a lot of this together yourself in a patchwork way it probably isn't worth it once you factor in the time-related costs, and the drag of having multiple systems that don't really talk to each other.

 

[lol.psych]

Oh boy, in SP's template library, there's a little dropdown menu to choose your profession so it only shows you relevant templates -- psychiatry isn't even an available option 🙃. They have one SOAP template and it's 4 open text boxes.

Another thing I'm pretty worried about is billing/coding -- in Luminello, you can choose your billing codes depending on what happened in that appointment (at the bottom of the note form), but SP doesn't have that, it wants you to put the billing codes in the calendar appointment itself. But I don't know ahead of time if someone's going to present with a subacute crisis or in an affective episode or totally stable, or how much of the appointment will be psychotherapy vs E&M.

I hope the early adopters/beta testers actually affect changes/updates.

 

[clozareal]

I agree with you Bartelby. You lose more than you get in my opinion. But here are some counterpoints for fun:

I think as tempting as paper charts sounds it's hard to go back. You lose:

-Instant creation of superbills

You can have a word doc to create your own PDF but yeah you lose out on this.

-Automated tracking of invoices and payments

This can be done with whatever you're using to bill patients. Google Merchant/Google Pay might work too but I haven't used it.

-A HIPAA-compliant messaging portal

Don't have a portal = no more messages from patients.

-Secure transmission of intake forms or rating scales

Have them upload it to your Google Drive. One Google Drive folder for each patient.

-Secure inquiries from new patients (linked to a website)

Google Forms.

-A fully digital "in the cloud" practice with no need for physical storage space and no safety concerns about physical records

Google Suite is fully digital. What's not digital?

-Ability to access your full EMR from anywhere, including while away on vacation

You can access Google Suite from everywhere.

-The guarantee that your patient-related systems are all HIPAA-compliant / under an existing BAA

Google has HIPAA compliant BAA that you signed.

 

[clozareal]

Oh boy, in SP's template library, there's a little dropdown menu to choose your profession so it only shows you relevant templates -- psychiatry isn't even an available option 🙃. They have one SOAP template and it's 4 open text boxes.

This is 4 more open text boxes than I want. I just want ONE text box for my note. Like Epic. I can format it and fill it out myself.

Another thing I'm pretty worried about is billing/coding -- in Luminello, you can choose your billing codes depending on what happened in that appointment (at the bottom of the note form), but SP doesn't have that, it wants you to put the billing codes in the calendar appointment itself. But I don't know ahead of time if someone's going to present with a subacute crisis or in an affective episode or totally stable, or how much of the appointment will be psychotherapy vs E&M.

Wait yikes that's going to be a problem... I'll need to test it out myself.

 

[calvnandhobbs68]

Another thing I'm pretty worried about is billing/coding -- in Luminello, you can choose your billing codes depending on what happened in that appointment (at the bottom of the note form), but SP doesn't have that, it wants you to put the billing codes in the calendar appointment itself. But I don't know ahead of time if someone's going to present with a subacute crisis or in an affective episode or totally stable, or how much of the appointment will be psychotherapy vs E&M.

That would be completely dumb if that was the case (in terms of formatting)

 

[lol.psych]

This is 4 more open text boxes than I want. I just want ONE text box for my note. Like Epic. I can format it and fill it out myself.


Wait yikes that's going to be a problem... I'll need to test it out myself.

You can have one open text box, I think that might be the default, even.

And, I was wrong -- it looks like you can change the billing codes, but you have to go to the pt's billing page and edit.

 

[Bartelby]

The no portal = no messages likely wouldn't go so great. I did part of residency without clinical messages and the phone tag, reaching a patient and having to firmly but politely avoid the interaction becoming an on the spot phone visit, and rambling voicemails (that you pretty much had to listen to) were so much worse!

I will say, though, that I have spoken with some private practice doctors who absolutely swear by paper charts and view that as one of the biggest perks of private practice! I personally don't think it would be for me, but it sounds like it works pretty well for some people.

 

[vanfanal]

Future private practice lurker here...
I see a lot of mention of iPrescribe or e-prescribe. What about old fashion prescription pads, are they not an option too?

 

[romanticscience]

You can have one open text box, I think that might be the default, even.

This is what I do. I pretty much copy forward the previous note and make small changes to history, severity of conditions, psychotherapy start/stop times, and focus on the therapy.

 

[calvnandhobbs68]

The no portal = no messages likely wouldn't go so great. I did part of residency without clinical messages and the phone tag, reaching a patient and having to firmly but politely avoid the interaction becoming an on the spot phone visit, and rambling voicemails (that you pretty much had to listen to) were so much worse!

I will say, though, that I have spoken with some private practice doctors who absolutely swear by paper charts and view that as one of the biggest perks of private practice! I personally don't think it would be for me, but it sounds like it works pretty well for some people.

I don’t have a portal and no way for patients to message besides calling and leaving a message. 90% of the time my admin assistant can deal with it or she just takes the message and I tell her what to say or to schedule an appt. I much prefer having some barrier between me and ridiculous questions or dumb stuff like “can you send this stimulant to this pharmacy now”.

If I had to call everyone back myself then yes I’d want a portal system.

Future private practice lurker here...
I see a lot of mention of iPrescribe or e-prescribe. What about old fashion prescription pads, are they not an option too?

Lots of states are requiring eprescribe for controlled meds. Also much easier to keep an audit trail of where you’ve sent meds when.

 

[Bartelby]

Lots of states are requiring eprescribe for controlled meds. Also much easier to keep an audit trail of where you’ve sent meds when.

Agreed, these days eprescribing is not really optional in many places.

 

[psycho-matic]

I think I've narrowed my list down to:
1. PracticeQ
2. Osmind

From what I can tell, PracticeQ provides similar functionality at a significantly lower price. Anyone have any feedback on these 2 platforms?

 

[clausewitz2]

Just had my Osmind demo, I agree that it looks good. Sending out regularly scheduled rating scales at a set interval you can tweak per patient that automatically generates a line graph and has a customizable threshold notification is pretty nifty. They have about 40 forms already built out (most of the ones I use) and when I asked about the one form I use often that they don't have yet (OCI-R), the rep made a point of taking notes and asking questions about it. I get the sense that they definitely will add more to the extent the demand is there.

I'm in a weird set-up at the moment re: billing, but honestly the billing interface looks straightforward enough that I might suggest next contract negotiation that I take responsibility for billing and up the percentage I keep. Giving a small cut to someone to provide somebody manning a phone, a physical address, internet presence, help with insurance credentialing, and re-scheduling in case of emergencies is something I'd be fine with long-term.

EDIT: Also re: snippets in Osmind, they integrate TextExpander, which is brilliant. Using Luminello I was actually paying for my own TextExpander subscription so more money saved.

EDIT EDIT: It also struck me that having an automated rating scale function with auto-graphs trivializes a fair number of potential PIP projects.

 

[clozareal]

Osmind has most of what I want. Integrated telehelath, EHR transfer, smart phrases/textexpander, integrated elabs, patient facing app, google calendar sync, good billing system.

Here are the drawbacks:

• It requires you to confirm every patient rescheduling, appointment, change. That’s annoying to me. Patients need to call or message you to cancel any appointment.
• Can’t search all notes with ctrl+F
• No fee schedules but the workaround is to customize the billing invoice for each patient.
• No prescreening forms yet but they are working on this for Q1.

I can work around those except for perhaps the search function. Otherwise, it looks great. It’s pricey but they include a lot of services that I’m paying for already so that’ll cut down on costs.

I’m deciding between PracticeQ and Osmind. Anyone know whether PracticeQ can help move everything over from Luminello?

 

[psycho-matic]

Osmind has most of what I want. Integrated telehelath, EHR transfer, smart phrases/textexpander, integrated elabs, patient facing app, google calendar sync, good billing system.

Here are the drawbacks:

• It requires you to confirm every patient rescheduling, appointment, change. That’s annoying to me. Patients need to call or message you to cancel any appointment.
• Can’t search all notes with ctrl+F
• No fee schedules but the workaround is to customize the billing invoice for each patient.
• No prescreening forms yet but they are working on this for Q1.

I can work around those except for perhaps the search function. Otherwise, it looks great. It’s pricey but they include a lot of services that I’m paying for already so that’ll cut down on costs.

I’m deciding between PracticeQ and Osmind. Anyone know whether PracticeQ can help move everything over from Luminello?

I've done the free trial with PracticeQ. It's amazing how customizable everything is. One can also set up different questionnaires to automatically be sent to patients at different intervals. There are dozens of scales available and you can edit them or create your own, too.

 

[Ahamis]

Simple practice has billing service which costs 6% of net insurance collection + $0.30 for each claim.

How much PracticeQ charges?
I couldn't find information about billing service for PracticeQ.

I believe Osmid charges $0.39 per eletronic claim submission, correct?

 

[clausewitz2]

Simple practice has billing service which costs 6% of net insurance collection + $0.30 for each claim.

How much PracticeQ charges?
I couldn't find information about billing service for PracticeQ.

I believe Osmid charges $0.39 per eletronic claim submission, correct?

2.5% + 0.30 i believe for Osmind

 

[ObsequiousAplomb]

Simple practice has billing service which costs 6% of net insurance collection + $0.30 for each claim.

How much PracticeQ charges?
I couldn't find information about billing service for PracticeQ.

I believe Osmid charges $0.39 per eletronic claim submission, correct?

2.5% + 0.30 i believe for Osmind

Isn't 2.5% + 0.30 the credit card merchant fees for Osmind? I didn't think Osmind had a billing service. If there really is a billing service only charging 2.5%, that would more than make up for the higher monthly rates.

 

[clozareal]

2.5% + 0.30 i believe for Osmind

Isn't 2.5% + 0.30 the credit card merchant fees for Osmind? I didn't think Osmind had a billing service. If there really is a billing service only charging 2.5%, that would more than make up for the higher monthly rates.

Osmind is 2.9% + $0.30/transaction. They use Stripe.

 

[psycho-matic]

Osmind is 2.9% + $0.30/transaction. They use Stripe.

Which one of these isn't using Change Healthcare? This has turned into a nightmare lately.

 

[Ahamis]

Isn't 2.5% + 0.30 the credit card merchant fees for Osmind?

I guess so.
I was specifically asking about billing service.
If Osmid does not have a billing service, how do you guys plan to submit the claims to the insurance?

What about PracticeQ?

 

[ObsequiousAplomb]

I just finished my demo with Osmind. I'm switching over to them.

I was very impressed with the workflow setup. It will streamline a lot of my administrative tasks compared to luminello. I will feel much more comfortable conforming to a 60-minute intake instead of 90-minute if patients fill out at least some of the intake paperwork through Osmind compared to luminello.

I mainly compared it to SP. I didn't bother with demos for others, as I really can't stand the choosing. No matter what I choose, I will eventually adapt to it and it will work.

I guess so.
I was specifically asking about billing service.
If Osmid does not have a billing service, how do you guys plan to submit the claims to the insurance?

What about PracticeQ?

Osmind does claim submission directly through ChangeHealthcare. They do not have a billing service. I submit all my own claims, so the lack of a billing service isn't a big deal to me (at least, for now). The idea of giving 6% ($10-15 per claim) to a service just isn't tenable for me right now.

 

[lol.psych]

Y'all, osmind comes with labcorp and quest integration from the get-go. Even for practices like mine that don't have enough volume for quest to make an account for. Don't know why, but that did it for me.

I wanted to want to switch to Sessions Health, and maybe I will in a year or two when they add e-rx functionality, but for now osmind seems pretty great.

 

[Bartelby]

Does anyone know how long Osmind gives the 35 percent discount for? For example, first month, first year?

 

[clozareal]

Does anyone know how long Osmind gives the 35 percent discount for? For example, first month, first year?

First 12 months after Luminello transfer.

 

[psycho-matic]

Osmind is also waiving the $75 EPCS setup fee. Does anyone know if with Osmind one can automate the sending of certain forms to patients? Let's say I want every patient to receive a PHQ-9 and GAD-7 two days before every appointment. Can it automate that, without my individually having to select which patients receive it? PracticeQ provides the ability to do this and pull the data in from the screenings into one's note.

Does Osmind automatically verify a patient's insurance info within the patient chart?

One thing that is odd to me...IntakeQ uses ScriptSure for e-rx. Apparently, SureScript requires one to have a second (administrative) supportive user on the account as part of setting up EPCS. The second user verifies the provider's identity and then approves the provider for EPCS. This is a problem for those in solo practices without any supporting staff, like me. They say it can be a parent, friend, spouse, etc. This seems fishy to me, and problematic from a HIPAA perspective. Luminello did not require this fore EPCS. They mailed an Experian transaction number to me that I had to enter to complete the identity proofing and EPCS setup. Does anyone know how Luminello gets around this supposed DEA rule? Can anyone shed some light on this?

Here is a link to the PracticeQ EPCS setup instructions: ePrescribe: Getting Approved for EPCS - IntakeQ & PracticeQ Guides

 

[calvnandhobbs68]

Osmind does claim submission directly through ChangeHealthcare. They do not have a billing service. I submit all my own claims, so the lack of a billing service isn't a big deal to me (at least, for now). The idea of giving 6% ($10-15 per claim) to a service just isn't tenable for me right now.

This ChangeHealthcare thing is a frickin mess and makes me happy that we have a biller that I'm pretty sure just manually electronically submits claims to each insurer....it's actually pretty scary how you can basically get held hostage for claims at this point. They're predicting "weeks" of being down and their best answer is "maybe we can loan money to people WE owe money to anyway?".

Wish I could do that to a bank "yeah sorry I can't pay you what I owe for a while because something happened to this system I was supposed to be maintaining".

United was already the biggest scumbags and now this is just insane.

 

[Bartelby]

One thing that is odd to me...IntakeQ uses ScriptSure for e-rx. Apparently, SureScript requires one to have a second (administrative) supportive user on the account as part of setting up EPCS. The second user verifies the provider's identity and then approves the provider for EPCS. This is a problem for those in solo practices without any supporting staff, like me. They say it can be a parent, friend, spouse, etc. This seems fishy to me, and problematic from a HIPAA perspective. Luminello did not require this fore EPCS. They mailed an Experian transaction number to me that I had to enter to complete the identity proofing and EPCS setup. Does anyone know how Luminello gets around this supposed DEA rule? Can anyone shed some light on this?

Luminello's e-prescribe system made me have an administrative support user on the account for setup. I found this fishy too but did it because they would not let me activate e prescribing without it. I made my spouse this admin person.

 

[psycho-matic]

Luminello's e-prescribe system made me have an administrative support user on the account for setup. I found this fishy too but did it because they would not let me activate e prescribing without it. I made my spouse this admin person.

I'm waiting to get my Experian transaction number in the mail. I literally just started with Luminello when they announced that they were shutting down. Did the request for an admin support user come after getting the Experian number in the mail?

 

[Bartelby]

I think it came after the Experian transaction number, but it's been long enough that I don't totally remember. I suspect that administrative supporter request is probably coming up though. It is bizarre for psychiatry, where so many of us set up solo practices.

 

[ObsequiousAplomb]

I thought the second person epcs setup requirements came from CMS. I could very easily be wrong.

I, too, had my spouse do it. She was too lazy to actually do it though, so I had to help her verify who I am. Very silly.

 

[psycho-matic]

I thought the second person epcs setup requirements came from CMS. I could very easily be wrong.

I, too, had my spouse do it. She was too lazy to actually do it though, so I had to help her verify who I am. Very silly.

It appears to be a DEA requirement.

 

[clozareal]

I thought the second person epcs setup requirements came from CMS. I could very easily be wrong.

I, too, had my spouse do it. She was too lazy to actually do it though, so I had to help her verify who I am. Very silly.

It’s a ridiculous requirement and administrative burden that doesn’t add anything other than that you know how to use 2 emails and can fake a second identity.

 

[psycho-matic]

Practiceq is offering free data migration and 50% off the first two months of service for Luminello users. The fact that they do not use Change Healthcare for their clearinghouse and are much less expensive than Osmind sealed the deal for me.

 

[Hawksok]

Just putting a data point out there that my Luminello is off and on non-functional right now. This was happening yesterday afternoon for me as well, then it started working again this morning (albeit extremely slowly and with crashes upon signing notes) My calendar has totally vanished: all my past and future appointments are gone, and my calendar is just blank. It appears I could enter appointments if I wanted. I often can't access any patient's chart, although I can see my roster of patients when this happens. It seems like messaging still works. I found an article online referencing similar experiences of someone else.

EDIT: Got a reply to my initial message to them asking about what was going on, acknowledging the issue: "We understand how painful this might be to your workflow, and we are terribly sorry for the difficulties experienced. Our development team is all hands on deck, working to restore stability..."

EDIT 2: they've updated the outage on status.luminello.com

Hopefully this is a one time thing, and isn't a sign of what the rest of our time with Luminello will be like.

 

[Ironspy]

Just putting a data point out there that my Luminello is off and on non-functional right now. This was happening yesterday afternoon for me as well, then it started working again this morning (albeit extremely slowly and with crashes upon signing notes) My calendar has totally vanished: all my past and future appointments are gone, and my calendar is just blank. It appears I could enter appointments if I wanted. I often can't access any patient's chart, although I can see my roster of patients when this happens. It seems like messaging still works. I found an article online referencing similar experiences of someone else.

EDIT: Got a reply to my initial message to them asking about what was going on, acknowledging the issue: "We understand how painful this might be to your workflow, and we are terribly sorry for the difficulties experienced. Our development team is all hands on deck, working to restore stability..."

Want to transfer your practice to SP which is owned by the private equity group responsible? I’m sure they will do a great job

 

[Sushirolls]

Yes this calendar issue is hurting.

And I've had other posts about the consolidation of UHC with purchasing ChangeHealthcare. UHC will become our defacto single payer system with time.

This Tuesday is feeling like a Monday.

 

[clozareal]

I have 7 hours of back to back patients today except for one 30 min block for lunch and cannot remember each one of them. This calendar being down is really annoying.

 

[clausewitz2]

I have never been gladder that I decided to start entering all new notes into not-Luminello starting yesterday.

 

[kmson613]

Has anyone used Vehrdict? They have a free version and even with all the add-ons it's reasonably priced. vehrdict.com