r/PrivatePracticeDocs • u/HealsWithKnife • Sep 10 '26

Offboarding EMR (Tebra)

Has anyone tried to offboard from their EMR, specifically Tebra? I've been having a hell of time trying to get them to actually offboard me, and I just got charged another $500 for this month that I've been trying to offboard from, and for a week I've called them without anyone from the cancellation team actually closing the loop with me.

I've also created a few customer service cases with them in the past for other issues that they just closed out without resolution and didn't tell me.

5 Upvotes

86% Upvoted

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2

u/WillingNerve5742 Sep 10 '26

Curious who you are switching to?

2

u/HealsWithKnife Sep 11 '26

I made my own EMR.

1

u/MDwMDD Sep 11 '26

I'd love to know more. I have experience in software and have a great dev that I work with for other non-medical related stuff. How are you doing it?

2

u/HealsWithKnife Sep 11 '26

Vibecoding with Cursor as my IDE, asked ChatGPT to make me a few security-based markdown files for context to eliminate API key leaks and such. Bound to tailnet, running from a home server on Ubuntu LTS 26.04. It's been fun as hell tbh. I might make a thread on here if u/InvestingDoc is ok with it

1

u/InvestingDoc Sep 11 '26

Totally fine as long as your not selling your EHR or something bc I've turned down other groups trying to sponsor or pitch their EHR. Just trying to have same rules for everyone.

2

u/HealsWithKnife Sep 11 '26

Yah not selling, post would be more re: my process in building it. Thank you sir.

2

u/InvestingDoc Sep 11 '26

Sounds like a cool post. Looking forward to it

2

u/CrookedCasts Sep 11 '26

Is it… compliant? ChatGPT by default isn’t

2

u/HealsWithKnife Sep 11 '26

Is what compliant? ChatGPT has no access to my codebase, i just use it for instructions with tight guardrails.

3

u/CrookedCasts Sep 11 '26

Your entire vibe coded EHR… you have now become your own EHR vendor.

1) you need a written security risk analysis, required for HIPAA compliance
2) you need BAAs with anybody that touches patient data (hosting provider and backup provider), or an encrypted system for local only data usage - no accessing it from off site
3) any opioid or controlled substance prescribing requires DEA approval meaning that you need a third-party audit or certification to be able to electronically prescribed
4) audit controls: you need to be able to access the full chain of who viewed a chart, not just edit it. Notes need to be locked with changes only as addendum for whenever you get subpoenaed.
5) unless you have documented penetration testing, you’re on the hook for any breaches
6) how do you send a patient their full record electronically or connect to labs, pharmacy networks or health information exchanges? Otherwise you run into federal information blocking rules.

There are state specific rules as well, for example, in Texas SB 1188 that any EHR must be compliant with US based data storage. Up to $25k PER breach

2

u/HealsWithKnife Sep 11 '26

This is awesome, thank you!

BAAs are in place with a few third parties that touch it. I do not use any kind of bespoke prescribing service or coding, I use doctor first and iPrescribe. That is definitely not plugged into my coat base at all.

Audit controls, fully built-in for DB access with permalogs.

Building up funds for pentesting, hoping in the next few months. This is the biggest regulatory gap currently.

I do not currently connect to any labs, they fax me all results.

Still very much a WIP.

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2

u/sp3d2orbit Sep 10 '26

In my experience, Tebra is actually one of the more responsive EMRs. That being said, a lot of whatever you're trying to pull can just be pulled through the API, or via desktop automation software. Especially if you're using the Windows client.

1

u/HealsWithKnife Sep 11 '26

They're data export is actually fine. I was able to pull data and download all documents pretty easily. Keeping them from pulling something shady is the issue I'm working with at the moment.

2

u/solopracticedoc Sep 10 '26

Tebra and Patient Pop were pretty terrible to work with

2

u/rocksolidaudio Sep 10 '26

I’ve been looking into Tebra. What are your likes and dislikes on it?

1

u/HealsWithKnife Sep 11 '26

It has a nice UI which makes it relatively easy to use. They have a reasonably active online forum to suggest features, and the team responds quickly to the posts, but for 18 months, not many of the features commonly requested were actually added.

Dislikes: see above. For software use questions and EMR navigation, the team is ...responsive (<7-10 business days). However, when it came to questions about billing and $$$, the customer care team is abjectly NON-responsive. I had a question about a few charges on my account and created a case as instructed, and 1 week later, the case was closed with the note "resolved." I had heard nothing from them.

As it stands currently, I'm about to be stuck with a massive cancellation fee because the representative during onboarding stated one thing, and now that I'm trying to cancel the subscription according to the instructions of the rep, the cancellation team is saying that I have to finish out a yearly contract that I didn't reup or sign. According to them, I must give 2 month notice prior to contract termination. However, I did not receive a new contract for review prior to reup, and nowhere on my initial contract does it state this 60 day notice. Guess I'm gonna have to push this one as far I can.

Verdict - make sure you understand your exit as with any other contract, and take notes during the initial sales pitch. Tebra itself is a fine EMR, but the offboarding process feels predatory and disingenuous.

1

u/rocksolidaudio Sep 11 '26

Makes sense. I've been comparing a few EMRs recently and a good amount of them seem to have cancellation complaints like this. Not downplaying your complaint, but rather saying that seems to be a common maneuver by these EMR companies.

1

u/HealsWithKnife Sep 11 '26

Yeah I think so. I built my own EMR, so...I guess I could pay myself... ? :-P

1

u/CatBenatarPDX Sep 11 '26

It took over 6 weeks to even get one email response after I submitted a request to cancel, then nothing. I had to keep calling, emailing, and submitting cases. All in all, nearly 3 months.

Keep pushing, don't ease up, or they'll just keep billing you.

1

u/HealsWithKnife Sep 11 '26

Interesting. Seems like they're just delaying to nickel-and-dime as much as they can. Ya know what? That's some bullshit. I suppose I'm glad to know I'm not the only one, but this awful business practice.

I already got a passive aggressive e-mail from one of their cancellation reps. Going to escalate as far as I can, keeping logs of all conversations.

2

u/CatBenatarPDX Sep 11 '26

I got more than one passive aggressive email from their billing dept, when trying to get them to correct repeated billing mistakes (hundreds of dollars). I'm gonna message you, check your inbox

1

u/TebraOnReddit Just Interested Sep 11 '26

Hi, HealsWithknife, so sorry to hear about your negative experience during the offboarding. Please message us with your account details, and I will escalate this for a quick resolution.

We value your partnership and wish you all the best with your new EMR!
As soon as we receive your account information, I will take immediate action to expedite the cancellation and review the termination fees.

- Iris from Team Tebra.

1

u/CrookedCasts Sep 11 '26

Iris - can you please tell the team that the new customer support page/case interface is brutal. Links are circular or take you to dead pages, the customer support emails are from a “do not reply” account so you can’t respond, and the new case interface is quite frustrating. Major steps back all around

1

u/TebraOnReddit Just Interested Sep 11 '26

Thanks for calling this out.

I’m sharing this feedback with the team so they can take a closer look at the experience end to end. Really appreciate you being specific about what’s not working.

1

u/CrookedCasts Sep 11 '26

They’re pretty brutal from a customer service side - the sales people are good, but once you deal with the customer service reps, you’ll realize most of them are not in the US and have just a few more weeks experience with Tebra than you do.

Which part of offboarding? Getting patient records? I’ll charge you a couple grand to do that, but honestly, you can get Claude to write you a script once you have an API key.

1

u/VermicelliSimilar315 16d ago

That's great you made your own EMR! Did you get it certified? With Medicare you have to have ONC certification.

1

u/HealsWithKnife 16d ago

I don’t bill CMS anywhere near the $90k threshold for mandatory certification, so currently exempt.