Ensora vs Upheal: which EHR is right for your therapy practice?
Every therapist has an EHR. TheraNest, now part of Ensora Health, has been one of the established options for over a decade, covering scheduling, billing, telehealth, and documentation for mental health practices. Its AI is branded Ensai, and it comes in two parts: a notes enhancement that polishes what you write, included on every plan, and the Ensai Session Assistant, an ambient scribe sold as a $35 per provider add-on on any tier.
Upheal is an AI-native EHR. The AI isn't a feature you unlock at the top tier. It's how the EHR works from the start. Notes connect to treatment plans and the client's full history. The compliance checker audits documentation before you sign. The AI assistant handles scheduling, billing, and the admin between sessions. At $1/session capped at $69/month, all of it is included.
Two EHRs, two different approaches to AI
TheraNest is an established EHR that added AI through Ensai. The notes enhancement, which polishes progress notes you have already written, is included on Essentials ($29), Advanced ($59) and Premier ($89). The Ensai Session Assistant, which records the session and drafts the note for you, is a separate $35 per provider add-on and is not bundled into any tier, including Premier. Verified against Ensora's TheraNest pricing page on 4 September 2026.
Upheal is an AI-native EHR. Notes connect to your client's full record: their treatment goals, diagnosis, what came up last week. The AI isn't something you add on. It's just how the platform works.
TheraNest (Ensora) vs Upheal at a glance
| Feature | Upheal ★ Best | TheraNest (Ensora) |
|---|---|---|
| Pricing | $1/session$69 cap per month | $29–$89/moPer therapist; Ensai scribe +$35 |
| AI Progress Notes | Included, all plans | Ensai add-on, $35/moAny tier; $64 with Essentials |
| AI Treatment Plans | Golden ThreadAuto-links to every session note | Wiley PlannerPremier, or +$25 on Advanced; not AI-linked |
| Compliance Checker | YesAetna + Optum standards | No |
| AI Assistant | YesFree tier; Pro $39/mo | Ensai Q&AWith the $35 add-on |
| Client Messaging with AI Drafts | Included | No AI draftsSecure messaging on Advanced+ |
| Forms | Fully customizableAI import from PDF | Yes, no AI import |
| Custom Note Templates from PDF | YesAI import from PDF | Basic, no AI import |
| Scheduling | Yes | Yes |
| Billing | Yes | Yes |
| Insurance Billing | Yes | Advanced + PremierNot on Essentials |
| Telehealth | Yes, free built-in | Advanced + Premier$12/mo add-on on Essentials |
| Client Records | Yes | Yes |
| Client Portal | Yes | Yes |
| Free Plan | YesUnlimited notes + telehealth | No21-day trial only |
| Security certification | SOC 2 Type II | HIPAA compliantHITRUST e1 covers their e-prescribe system, not the EHR |
Where Upheal goes further
The AI assistant.
The Ensai Session Assistant records the session and drafts a note, and its AI Case Summaries pull a client's history into one summary. That is a real capability, and the add-on is cheaper than most. Upheal's AI assistant connects to the full clinical record and works before and between sessions too. Before your next client, it pulls their history, open goals, and what hasn't shifted. It drafts discharge summaries, referral letters, and client messages from the actual record, and handles scheduling changes and billing admin between sessions.
The Compliance Checker.
Upheal audits notes against payer standards before you sign. If a note is missing a required element, you find out before the payer does. Nothing in the Ensai suite audits a note against payer requirements, and for practices that bill insurance, that check is a meaningful addition.
Forms with AI import.
Upheal's forms are fully customizable, and you can drop a PDF of any existing form and Upheal recreates it digitally using AI. TheraNest has custom intake forms from Advanced upward, but no AI import. For practices switching EHRs with years of existing intake paperwork, this removes one of the bigger transition friction points.
Pricing
TheraNest's per-therapist pricing runs Essentials $29, Advanced $59 and Premier $89 a month, with annual billing at $27, $54 and $82. Essentials covers scheduling, the client portal and basic notes, with telehealth as a $12 add-on. Advanced adds custom forms, online booking and telehealth. Premier adds insurance billing automation and the Wiley Treatment Planner.
The AI sits outside all of that. The Ensai Session Assistant is $35 per provider per month on any tier, so the cheapest ambient-scribe setup is Essentials plus Ensai at $64 a month, and a full Premier practice with the scribe is $124. For four clinicians on Premier with Ensai, that is $496 a month. There is also a $19.50 annual AMA CPT licence fee per therapist.
Upheal is $1/session capped at $69/month per clinician, with AI notes, treatment plans, compliance checking, scheduling, telehealth, billing, and the AI assistant all included. A lighter caseload pays less.
Insurance billing is live in Upheal, with claims submission, ERA processing and eligibility checks built into the platform. Billing fees apply per claim, see the pricing page for details. If billing was the reason you stayed on TheraNest, that reason is gone.
What TheraNest actually costs for a therapy practice
TheraNest is a reliable mental health EHR with a genuine track record. Insurance billing infrastructure is mature, the platform has been around for over a decade, and it works for practices where the basics are the priority.
Choose TheraNest if:
- You want a cheap ambient scribe attached to an established EHR, and $64 a month on Essentials plus Ensai fits
- You value a 10+ year track record and established billing infrastructure
- Per-therapist pricing fits your practice size
Choose Upheal if:
- You want AI built into the EHR rather than bought as a per-provider add-on on top of a per-therapist plan
- You want notes that connect to treatment goals and prior clinical history
- You want a compliance checker that audits documentation before claims go out
The comparison is not that TheraNest hides AI behind a top tier, because it does not. It is that TheraNest's AI stops at the note, and you pay a per-provider add-on on top of a per-therapist plan to get it. Upheal is $1/session capped at $69/month with AI notes, treatment plans, compliance checking, scheduling, billing, and an AI assistant all included.
Try Upheal free. AI included from day one, not as a per-provider add-on.
Unlimited notes and HIPAA-compliant telehealth on the free plan. AI notes, treatment plans, compliance checking, scheduling, and billing at $1/session.
No credit card required.
Frequently asked questions
What is Ensora Health?
Ensora Health is the company behind TheraNest, a practice management EHR for mental health practitioners covering scheduling, billing, documentation, telehealth, and client records. Its AI is branded Ensai. A notes enhancement is included on every plan, and the Ensai Session Assistant scribe is a $35 per provider monthly add-on.
How does Ensora pricing compare to Upheal?
TheraNest plans run $29, $59 and $89 per therapist per month. The Ensai scribe is a further $35 per provider on any tier, so an AI-documented setup starts at $64 and reaches $124 on Premier. Upheal is $1/session capped at $69/month with AI notes, treatment plans, compliance checking, scheduling, billing, and telehealth all included.
Does Ensora have AI notes?
Yes. The Ensai notes enhancement, which polishes notes you have written, is included on all three plans. The Ensai Session Assistant, which records the session and drafts the note, is a $35 per provider monthly add-on available on any tier rather than a Premier-only feature.
Does Upheal have insurance billing?
Yes, Upheal now has insurance billing. On TheraNest, claims processing starts on Advanced with a monthly free allowance and per-claim fees after it, and insurance billing automation is Premier only.
Can I switch from Ensora to Upheal?
Yes. Upheal covers scheduling, billing, client records, AI notes, treatment plans, compliance checking, telehealth, and intake forms. It replaces Ensora in one platform.
