Account Types and Privileges

Role-Based Access Control

The HIPAA Privacy Rule requires that covered entities provide the members of their practice with access to only the minimum necessary information needed to perform their work, given their particular role in the organization. Health care organizations are expected to develop policies and procedures and implement security measures that comply with the minimum necessary standards. One way that TherapyAppointment assists you in meeting your minimum necessary access requirements and documenting your minimum necessary access decisions is by defining the various levels of privilege for the account designations and roles within the application. Below, you will find the general levels of privilege granted to each potential account designations and role options within the application. 

Each account is issued to one individual and is not to be shared. Every person who needs access to the application, including practice Account Owners and administrative staff, must have their own account under their own name and email address. Shared generic user accounts, meaning a single login used by more than one person, such as an administrator account shared across the practice, are prohibited by the Terms of Service and the Business Associate Agreement. Application activity is recorded against the account that performed it, so a shared account leaves no record of which individual took a given action. TherapyAppointment Customer Support cannot assist with requests related to obvious generic or shared accounts. The Protecting User Accounts policy sets out the full account provisioning, password, and multi-factor authentication requirements. 

The access described under each role below is the access carried by that role on its own. A user may hold more than one role, and where roles are combined the user’s access is the sum of the privileges each role carries.

Privileged Roles

The roles and privileges in this section are the broadest in the application. Account Owners, Managers, and Staff Administrators act across the entire practice rather than within a single clinician’s caseload and can change who else has access. Account Owners and Managers also have practice-wide access to client records, and a Records Custodian can view and release clinical records for some or all of the practice’s therapists. Grant these only to the individuals who require them and review the assignments regularly.

Account Owner

Clinical records access: full. An account owner can view every client record in the practice, including chart notes, and can print, release, redact, and add addenda to any chart.

Each practice may only have one Account Owner. 

An account owner, usually the first account set up for the group, can:

• Manage all practice settings.
  • Enable Zoom integration.
  • Establish and Modify Authorized User for the practice.
  • View and download the practice’s signed agreements with TherapyAppointment, including historical versions that have since been superseded
• Manage all staff for the practice.
  • Manage all role designations of all staff.
  • Manage all role-specific settings.
  • Manage permissions related to the  Records Custodian role designation. 
  • Manage supervisor/supervisee designations.
• Manage all billing and insurance settings for the practice.
  • View the practice’s TherapyAppointment billing history.
  • Manage all claims settings, CPT codes, and practice insurance configurations.
  • Manage payment processing settings and integrations.
• Manage all chart templates and documents.
• Manage all security settings for the practice.
  • Enable client delete and set retention threshold
  • Enable SSO
• View all clients and client records in the practice.
  • Delete client records that are no longer required for retention.
  • Print/Release chart notes for the practice.
  • Add an addendum to any chart in the practice. 
  • Redact/unredact any chart in the practice. 
  • Administratively lock a chart note that a departed therapist left unsigned *
• View all practice level reports.
• Send messages to all clients of the practice and all members of the practice. 
• Perform administrative actions on behalf of a Therapist in their practice.
• Deactivate the practice

*An administrative lock closes a chart note that a departed therapist left unsigned. It is not a clinical signature and makes no determination about whether the note is complete or accurate. It changes the note’s status from open to permanently closed, and the chart and its audit log record that the note was closed administratively rather than signed and identify the user who closed it. Amendment requests for an administratively closed note are handled as an addendum. Account Owners and Manager are the only users who can apply an administrative lock. 

If the practice Account Owner is also a clinician, they will use this account to schedule their own patients, chart notes, etc. 

An individual clinician is always classified as a practice Account Owner. In addition, practice Account Owners are, by default, also therapists. 

Manager 

Clinical records access: full. A Manager has the same client record access as an Account Owner, including chart notes, redaction, and addenda. 

A manager for a practice has the same abilities as an Account Owner, EXCEPT THEY CANNOT:

• View the practice’s TherapyAppointment billing history,
• Change the payment method for the practice’s TherapyAppointment account, 
• Enable client delete for the practice (a Manager may delete client records once the Account Owner has enabled the feature), 
• Modify the Authorized User for the practice (this is view-only for a Manager), or
• Deactivate the practice. 

A Manager role includes the Scheduler and Biller roles by default. 

Additional permissions available for a Manager role include:

• Reporting: Allows this Manager to access practice-wide reports.

Staff Administrator

Clinical records access: none. A Staff Administrator cannot view client records or chart notes. This role does carry practice-wide control over staff accounts and authentication settings, including role assignment and multi-factor authentication enforcement. 

A staff administrator for a practice has the abilities to:

• View all data on the Staff page in the Practice Settings,
• Create staff users, 
• Edit the following information for staff users:
  • Personal Information,
  • Mailing Address,
  • Time Zone,
  • Primary Email Address (except in the case of Account Owners or other Staff Administrators),
  • Secondary Email, and
  • Secondary phone numbers.
• Reset/Disable multi-factor authentication (except in the case of Account Owners or other Staff Administrators),
• Disable staff user accounts for the practice (except in the case of Account Owners, Managers,  and other Staff Administrators),
• View all roles assigned to Staff in the practice,
• Edit roles for staff (except in the case of Account Owners, Managers, and other Staff Administrators),
• Force a password reset for staff users, 
• Change the following security settings in Practice Settings:
  • MFA enforcement,
  • Automatic sign-out for idle users, 
  • Simultaneous login limit, 
  • Client initials when syncing calendar, 
  • Single sign-on (SSO), and
  • Inactive staff/patient lockout.
• View staff user security logs, including:
  • Login/Logout events and
  • Password reset and MFA activities
• Message all practice staff.

Records Custodian

Clinical records access: the clinical records of the therapists they are designated to. A Records Custodian can view and release session notes, treatment plans, and stored documents designated as clinical. 

Records Custodian is an add-on privilege rather than a standalone account type, and it can be granted to any clinician or staff member by the Account Owner of the practice. A Records Custodian that is granted access to a therapist’s records can view and release client information that includes:

• Session Notes,
• Treatment plans, or 
• Stored Documents designated as ‘clinical’.  

When this privilege is assigned, the Records Custodian may be granted the privilege of viewing/releasing records for all therapists in the practice or may be limited to view the information for only certain therapists. This role may be granted for a specified time period or indefinitely.  

Additional permissions available for the Records Custodian that may be enabled by the practice Account Owner:

• Chart redaction for any chart for which they have read access granted. 
• Ability to add addenda for any chart for which they have read access granted.

Clinical Roles and Permissions

Adding any of these roles will make this new staff member a therapist in your practice able to manage, schedule, and chart their own clients.

Therapist

Clinical records access: their own clients only. A Therapist manages the charts of the clients assigned to them. A Therapist can also be given access to another clinician’s client, either by the client being assigned to more than one clinician or through chart sharing. 

This is an account designation designed for a user who sees clients and creates chart entries. This is a billable account. A Therapist role may or may not be attributed to a practice Account Owner.

A Therapist can: 

• View their Supervisors.
• Manage their schedule.
  • Add client appointments
  • Add meetings
• Manage their clients.
• Manage their schedule and availability.
• Manage their forms, templates, and documents.
• Manage their client charts.
• Manage their client portal and online scheduling settings. 
• Manage their Supervisees. 
• Export and import their client data. 
• Send messages to their clients and other members of the practice.

Additional Permissions available for a Therapist account include:

• Allows this therapist to use integrated telehealth (article here)

• Allows this therapist to use their own integrated Zoom account (article here)
• Requires an account owner or manager to enable first

• Allows this therapist to use integrated ePrescribe services powered by DoseSpot (article here)

• Allows this therapist to generate AI chart note

• Allows this therapist to process client payments via cash, check, or credit card processing (if enabled) for their own clients
• Does not allow access to their client financial screens

Allows this therapist to do the following for their clients only: 

• View/edit financial transactions and financial history in the client’s accounting screens
• Edit, submit, correct, and resubmit claims
• Process client payments via cash/check/credit card

Allows this therapist to view reporting and financials for their own sessions.

Prescribing Agent (DoseSpot)

Clinical records access: no additional. A Prescribing Agent works only within the prescribing function on behalf of the practice’s ePrescribe clinicians and does not have access to client charts. 

A prescribing agent can create, send, change, and refill non-controlled prescriptions on behalf of all ePrescribe Clinicians at the practice.

A prescribing agent can create, send, change, and refill non-controlled prescriptions on behalf of all ePrescribe Clinicians at the practice.

Administrative Roles

Enabling either of the roles below provides this user practice-wide access to view and manage all therapists’ schedules and the non-clinical information within client profiles.

Scheduler

Clinical records access: none. A Scheduler works with appointments and with the non-clinical information in client profiles and does not have access to chart notes or other clinical documentation.

A user with the Scheduler role can: 

• Schedule appointments/meetings for the therapists in the practice,
• Reschedule appointments/meetings for therapists in the practice, and 
• Cancel appointments/meetings for therapists in the practice.

Biller

Clinical records access: none. A Biller works with claims, accounting, and payments for all clients in the practice and can see CPT codes attached to a transaction. A Biller cannot see chart notes or other clinical documentation. 

A user with the Biller role can: 

• Manage the therapists’ schedule,
• Submit and manage client claims,
• Process client payments,
• Edit accounting and claims for all clients, and  
• Enter EOBs for the practice. 

Relationships

Supervisor Relationship

Clinical records access: the charts of designated supervisees, including private notes.

The Supervisor relationship is intended for the use of a Clinical Supervisor who needs to oversee charts of certain clinicians, review/approve charts, review/approve addenda, or provide supervision to therapists and/or interns that have been designated as supervisees by the practice Account Owner or Manager. It is an enhanced Therapist account and has the potential to have access to review charts, including private notes of any clinician who is designated as a supervisee. Be very cautious if you have one of these relationship designations; you usually have to ensure that your HIPAA disclosure to your clients spells out who has access to their private chart notes. A practice Account Owner or Manager assigning the supervisor/supervisee designation acknowledges that they are aware of the HIPAA requirements surrounding access to review chart notes.

When a Supervisor approves and locks a supervisee’s chart notes, that lock is a clinical attestation in the same way a therapist’s own signature is. It is distinct from the administrative lock described under Account Owner, which closes an unsigned note without attesting to the content of the note. 

Who might need a Supervisor designation:

• Supervisor of interns
• A person in charge of releasing chart notes for the group practice
• A person in charge of ensuring continuity of treatment and auditing the charting practices of the group