Documentation9 min read
SOAP, DAP, or BIRP: which note format should you use?
Three structures for the same clinical facts. What each format is good at, one therapy session written all three ways, and how to choose one and stay with it.
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E-prescribing
Prescribe from the chart the note was written in.
Electronic prescribing for the prescribers in your practice — controlled substances included — sent over the Surescripts network from the same record that holds the diagnosis, the plan, and last week's note. Billed per prescriber, so the therapists on the account never pay for it.
Does Congruent's e-prescribing cover controlled substances?
Yes. Congruent supports electronic prescribing of controlled substances (EPCS) as well as non-controlled medications. EPCS is federally regulated: the prescriber completes identity proofing once, and every controlled-substance prescription is signed with two-factor authentication before it is transmitted. Prescriptions reach the client's pharmacy over the Surescripts network. E-prescribing is a paid add-on billed per prescriber per month, and clinicians who do not prescribe are never charged for it.
Most outpatient mental health practices are therapists, with a psychiatrist or psychiatric nurse practitioner somewhere in the picture — on staff, on contract, or across town. The question is whether the prescriber works inside the same record as the people doing the therapy, or beside it. The chart already holds the diagnosis being treated, the plan, and the note from Tuesday. The prescription should come from there. How it is billed.
One record
The medication list lives next to the plan, not in a separate system.
When the prescriber uses a different system from the therapist, the medication list is a thing somebody retypes into an assessment, and the reason for a dose change is a thing somebody remembers to mention at the next team meeting. Neither of those is a records process. Both of them are how a chart drifts.
In Congruent the prescription is written in the chart, so the medication list is simply true — it is the list of what was sent. The therapist sees it beside the plan. The prescriber sees the therapy note before renewing. Why a single record matters at audit time →
- Current medications listed in the chart, beside the treatment plan and the last progress note
- Prescriptions sent to the client's pharmacy over the Surescripts network
- The therapist's note and the prescriber's script share one client record and one audit trail
- Available on the $20 Solo plan and the $29 Practice plan alike, per prescriber
- Sertraline 50 mg, dailysent 08/19
- Hydroxyzine 25 mg, as neededsent 08/19
Beside it, in the same chart
- Objective 1.2 — PHQ-9 to 9 or below by 12/15
- Last therapy note 08/12: sleep improved, GAD-7 12
- Diagnosis on file: F33.1, F41.1
Sample data for a fictional client.
Controlled substances
EPCS, with the two things the DEA requires and nothing bolted on.
A good deal of psychiatric prescribing is Schedule II through IV — stimulants, benzodiazepines, some sleep medications. An e-prescribing feature that stops at non-controlled medications sends the prescriber back to paper for exactly the prescriptions where a paper trail is the most work.
Electronic prescribing of controlled substances is governed by federal rule. It asks two things of a prescriber: prove who you are once, and sign each controlled prescription with a second factor. Congruent does both inside the chart. It does not ask for a separate login, a separate device, or a separate subscription.
- 01
Identity proofing
Once per prescriber, before the first controlled-substance prescription. Set up during onboarding.
- 02
Prescription written
In the chart, against the client's current medication list, with the diagnosis and plan in view.
- 03
Two-factor signature
Every controlled-substance prescription is signed with a second factor before it leaves.
- 04
Transmitted
Over the Surescripts network to the pharmacy the client chose. No paper, no fax, no phone call.
Who pays
Billed per prescriber, not per practice.
Every AI feature on this site is in the base price, and that is not changing. This is the one add-on, and it is priced the way the cost arrives: the e-prescribing network charges per prescriber, so we do too, and nobody else on the account sees the line.
E-prescribing — including EPCS for controlled substances, over the Surescripts network — is the one paid add-on. It is billed per prescriber per month on top of either plan, and only to the clinicians who prescribe; therapists on the same account are never charged for it.
- Added per prescriber, per month, on top of the Solo or Practice plan
- Therapists, counsellors, and social workers on the same account are never billed for it
- A group of six clinicians with one prescriber pays for one
- Remove it when a prescriber leaves and the charge stops on the next cycle
- 5 × TherapistPlan price only
- 1 × Psychiatric NPPlan price + e-prescribing
Related reading
- Compliance8 min read
What is golden thread documentation?
The golden thread ties assessment, diagnosis, treatment plan, and progress notes into one defensible record. What payers look for, and how to keep it intact.
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Bring one prescriber and try it.
Set up EPCS identity proofing during onboarding and send a real prescription inside the trial. The BAA is countersigned first, and the per-prescriber fee is on the pricing page, not in an email you get later.
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