Ease vs Heard | The Complete Practice Back Office
Ease vs Heard
Heard calls itself the financial platform for private practice. It does not process patient payments, does not pay your vendors, does not handle legal or HR, and outsources payroll to Gusto. A financial platform should do all of that.
Bookkeeping and Taxes. Not a Back Office.
Heard is a bookkeeping and tax service for therapists, packaged in a clean app. The team is solid and the tax work is real. If you only need bookkeeping and a tax return, Heard does that part well.
The problem is the positioning. A private practice has more financial moving parts than books and a 1040. Payments from patients. Bills from landlords, software vendors, malpractice carriers, and supply companies. Payroll for the practice owner and the team. Contracts, HIPAA agreements, and employee policies. Entity formation, registered agent service, and state compliance work. Heard does none of those things.
Ease does all of them, and the AI agent runs the work for you.
| Heard | Ease | |
|---|---|---|
| Bookkeeping | Included. | Included. |
| 1040 Tax Returns | Included. | Included. |
| Patient Payments | Not offered. | Included. Ease Pay. Card processing, memberships, invoices. |
| Vendor & Landlord Bills | Not offered. | Included. |
| Payroll (Owner & Team) | Outsourced to Gusto. $39/mo plus $6/employee. | Built into Ease. All 50 states. |
| Contracts & HIPAA Agreements | Not offered. | Included as a paid skill. Healthcare-trained. |
| State Compliance & Entity Formation | Not offered. | Included. Multi-state. MSO-PC capable. |
| AI Automation (Runs the work for you) | No. Human bookkeeping team. | Yes. Ease Agent. |
Feature Comparison
Feature
| Heard | Ease | |
|---|---|---|
| Built for doctors and clinicians | Therapists and wellness practitioners only. | Yes. Every clinical specialty. |
| AI agent does the work | No. Human bookkeeping team. | Yes. Ease Agent. |
| Bookkeeping | Included. | Included. |
| Embedded payroll | No. Outsourced to Gusto. | Yes. Built into Ease. All 50 states. |
| Bill pay and vendor management | Not offered. | Included. |
| Patient payments | Not offered. | Included. Ease Pay. |
| Entity formation and registered agent | Not offered. | Included. Multi-state. MSO-PC capable. |
| Legal, contracts, and compliance | Not offered. | Included as a paid skill. |
| HR and team management | Not offered. | Included. |
| Tax filing | Included on Essential and Premium. | $1,000 to $2,500. Included in Full Service. |
| Multi-specialty support | No. Mental health and wellness only. | Yes. |
| Starting price | $129/mo Lite. $169/mo Essential. $255/mo Premium. | $299/mo. $99/mo for first 3 months. |
What Heard Does Not Do
Heard's homepage calls it "the only financial platform built for private practice." A financial platform should give you a complete picture of practice finances. Heard does not.
- No Patient Payments: Heard does not process those payments. You pay another tool (Stripe, Ivy Pay, Square, your EHR's payment processor) to take patient money, then send transaction exports to Heard for the books.
- No Bill Pay: Heard does not pay any vendor bills. You would need to manage payments through your bank, card, or a separate tool.
- No Embedded Payroll: Heard 'Premium' includes payroll but relies on Gusto at additional costs.
- No Legal, Contracts, or Compliance: Heard does not handle therapy contracts, HIPAA agreements, or employment agreements.
- No HR or Team Records: There’s no place in Heard to manage team members and their records.
- No Entity Work Beyond S Corp Election: Heard only files Form 2553; any other entity formation must be done elsewhere.
- Therapy and Wellness Only: Heard is restricted to certain specialties and cannot be used by many other healthcare practitioners.
Who Should Pick What
Pick Heard if…
You need books and a tax return.
You are a solo therapist or wellness practitioner. You want bookkeeping and tax filing only. You are comfortable paying for separate tools for patient payments, bill pay, legal, and HR.
Pick Ease if…
You want one product for the whole back office.
You want one product that covers patient payments, vendor bills, payroll, bookkeeping, taxes, legal, HR, and entity work.
Pricing Compared
What you actually pay
| Heard | Ease | |
|---|---|---|
| Price | $129 – $255/mo | $299/mo |
| Rate Structure | Lite is $129/mo (no tax filing). Essential is $169/mo. Premium is $255/mo with extra payroll costs. | Ease Agent and FinancialOS, with all services included. $99/mo for first 3 months. |
Switching from Heard in Three Simple Steps
- Bring your books: Ease imports your transaction history and tax-categorized expenses from Heard in one step.
- Set up everything Heard does not: Connect Ease Pay for patient payments and setup Ease Bill Pay for vendor bills.
- Start chatting with the agent: Most therapists report a seamless transition with the agent feeling natural by week three.
Frequently Asked Questions
Why does Heard's pricing look cheaper?
It looks cheaper because the scope is narrower. The overall cost of using Heard plus other tools is often higher than Ease alone.
Is Heard's payroll actually Gusto?
Yes. The payroll product inside Heard Premium is Gusto, white-labeled.
Can I use Ease if I also serve non-therapy clients?
Yes. Ease has no specialty restriction.