STRAIGHT ANSWER
Behavioral Health EHR Pricing, Compared. You are paying for people who pick up.
Written for Washington agencies putting quotes side by side. Cheaper systems exist. This is what the difference buys, where volume pricing kicks in, and the three cases where we are the wrong fit.
There are cheaper behavioral health EHRs. This is what the difference buys.
KeyNotes is $99 per user per month with a one-time $1,495 setup, and volume pricing once you are past twenty users. Every feature, every user, no per-module pricing.
What the money buys is not a longer feature list. It is a small team you can actually reach. You call and you talk to us — the people who build and support KeyNotes. If something is broken, we fix it ourselves, and you deal with the same people from the first call to the fix.
You get a person, not a queue position. That is a deliberate part of the product, and it is a large part of why we are not the cheapest option on your list.
Five questions that decide the real cost.
Ask every vendor on your list these five, on a call, not from a brochure. Our answers are below. Compare them to whatever you hear elsewhere.
Are the WA BHO and King County reports already built, or will I be paying to have them made?
KeyNotes: Already built, and in production. Eight Washington agencies run KeyNotes and submit to BHO today. The reports ship with every plan and your reporting document setup is part of onboarding — nobody rebuilds a submission in a spreadsheet.
Press hardest here, and ask for a live screen rather than a checkmark on a feature grid. BHO reporting is not magic — it is a set of reports, and plenty of systems can be made to produce them. The question is whether they already exist and are in use, or whether you are commissioning custom report development and waiting. If a system makes your billing staff export to a spreadsheet and rebuild each submission, the licence saving comes back out of payroll, and payroll costs more than software.
What is the real first-year cost at my actual headcount?
KeyNotes: $99 per user per month, every feature and every user included, plus a one-time $1,495 setup. No per-feature tiers and no upcharge for electronic billing. At ten clinicians that is $990 a month. Past twenty users it is quoted — volume discount on licences, scoped onboarding, and a custom support tier with an SLA. Ask for the number rather than assuming the published one.
Get every number written down with setup included, then add what is not included: servers, backups, IT time, per-module upgrades, paid add-ons. A licence that looks cheapest on a spreadsheet often is not once you price the machine it runs on and the person who maintains it.
When something breaks, who picks up the phone?
KeyNotes: We do. You call 509.949.2162 during Pacific business hours and you talk to the people who build and support KeyNotes — often the same engineer who wrote the feature you are asking about. If something is broken, we fix it. Your plan includes two hours of support of any kind each month; past that it is $129 per hour, billed by the minute, no retainer and no minimum.
Billing by the minute is deliberate. When support is priced into every licence, the agencies that rarely call are paying for the ones that call daily. We would rather you paid for the time you actually used — most agencies are under an hour a month once they are running. Whichever model you prefer, ask every vendor on your list the same two questions: who answers, and what happens to your problem after you hang up.
Can I see the Business Associate Agreement before I commit?
KeyNotes: It is published on this site. Send it to your attorney before you talk to us again if you want. PHI is encrypted in transit and at rest, backed up nightly off-site, and hosting, SSL and security maintenance are handled on our side.
A vendor who will not show you the BAA until contracting is telling you something.
If I leave, what happens to my data?
KeyNotes: Month-to-month after setup, cancel with 30 days notice, and we deliver a full database export in the format you want — CSV, SQL or JSON. Your data is yours.
Ask what the export actually contains and in what format. “We can provide a report” is not the same as handing over your database.
Every feature, every user, no module games.
- WA State and King County BHO reporting
- Full clinical suite — progress notes, treatment plans, group notes, documents
- Patient ledgers and electronic billing
- KeyCal scheduling with automated tasks
- Secure internal messaging
- Multi-user permissions and roles
- Standard report library and admin reporting
- Nightly off-site backups, encryption at rest and in transit
- Hosting, SSL and security maintenance
- Two hours of support each month
- Data import from your prior EHR
- Custom form development
- Custom report development
- On-site training beyond standard onboarding
- Custom integrations — lab, pharmacy, clearinghouse
- Support time past the included two hours
When we are the wrong choice.
We would rather say this on a web page than three weeks into an implementation.
You are outside Washington State
Our reporting advantage is WA State and King County BHO submissions. Take that away and you are paying a premium for something you cannot use. Agencies elsewhere should weigh us on the clinical and billing suite alone, and that is a closer fight.
You need e-prescribing, eMAR or a patient portal today
KeyNotes does clinical documentation, scheduling, billing and BHO reporting. If medication administration or a patient-facing portal is a requirement rather than a nice-to-have, there are products built around those and you should look at them.
You would rather never speak to anyone
Some agencies want a self-service portal, a knowledge base and no phone call ever. That is a reasonable preference, and there are good products built around it. KeyNotes is built the other way round, so you would be paying for something you do not want.
Price is the only deciding factor and your reporting is simple
If you bill one payer, submit little, and have someone in-house who already handles it, a cheaper per-user system will serve you and we will not pretend otherwise.
Eight Washington agencies run KeyNotes and submit to BHO today.
Serving behavioral health agencies across Washington State since 2005.
Thirty minutes on your actual workflows — clinical, billing, BHO reporting — on real screens, with your headcount and your first-year total written down. Do the same with everyone else on your list and compare what you saw rather than what you read.
