You’ve decided to leave Tebra (formerly Kareo). Maybe your costs jumped 40-60% after the PatientPop merger. Maybe you experienced too many billing system outages that delayed claims submission. Maybe you’re frustrated with features being deprecated as Tebra pivots toward enterprise clients at the expense of small practices.

Whatever your reason, canceling your Tebra/Kareo contract requires careful planning. Unlike some SaaS services where you can click “cancel” and walk away, healthcare software involves data retention obligations, contract notice periods, and migration planning to avoid disrupting patient care and revenue cycles.

This comprehensive guide walks you through the exact cancellation process, critical timelines, data preservation requirements, and how to transition smoothly to a new EMR without losing patient records or outstanding claims.

Understanding Tebra’s Cancellation Policy

Before you contact support or make any moves, understand exactly what Tebra’s Terms of Service require for contract termination.

The 60-Day Notice Requirement (Verify Your Contract)

While Tebra’s general Terms of Service don’t explicitly state a universal cancellation notice period applicable to all customers, many Tebra/Kareo contracts include specific termination notice requirements - typically 30, 60, or 90 days depending on your contract date and plan type.

Critical Action: Before proceeding, locate and review your original Tebra/Kareo contract or order form. Look for sections titled:

  • “Term and Termination”
  • “Cancellation Policy”
  • “Termination Notice Period”
  • “Contract Duration”

These sections will specify:

  • Required advance notice (30, 60, or 90 days)
  • Whether your contract auto-renews
  • Early termination fees (if applicable)
  • Final billing procedures

Common Notice Periods by Plan Type:

  • Month-to-Month Plans: Often 30 days notice
  • Annual Prepaid Plans: May require 60-90 days notice before renewal
  • Multi-Year Contracts: Typically 60-90 days notice, with early termination fees if canceling before contract end date
  • Managed Billing Services: Often 60-90 days notice with specific claims run-out provisions

Why This Matters: If your contract requires 60 days notice and you submit cancellation on February 1st, your account won’t terminate until April 1st (or later). You’ll be billed for those two additional months, and you’ll need to maintain access during that period.

No Refunds on Prepaid Subscriptions

Tebra’s refund policy is clear and unambiguous:

Tebra does not refund or credit subscription fees for partial months or for any portion of a prepaid plan upon account cancellation.

What this means in practice:

Scenario 1: You prepaid for an annual plan at $3,000 (paid upfront in January). You cancel in March. You receive no refund for the remaining 9 months.

Scenario 2: You’re billed monthly at $250/provider. You cancel mid-month on March 15th. You’re charged for the full month of March. No prorated refund for March 16-31.

Scenario 3: You have 5 providers. You want to deactivate 2 providers mid-month. Tebra bills you for those providers for the full month and may assess an early termination fee for provider removal.

Strategic Timing Recommendation: Time your cancellation to align with your billing cycle end date. If you’re billed on the 1st of each month, submit your cancellation notice to take effect on the last day of a month (e.g., effective March 31st) to avoid paying for an extra partial month.

Early Termination Fees

Tebra’s Terms state: “Any Providers that are removed or deactivated are charged in advance for the last full month and, at Tebra’s discretion, may be subject to an early termination fee for the remainder of the term.”

When Early Termination Fees Apply:

  • You signed a multi-year contract (2-3 years) and cancel before the contract end date
  • You negotiated discounted pricing in exchange for a minimum commitment period
  • You’re on a Managed Billing service plan with minimum contract duration

Typical Early Termination Fee Structures:

  • Percentage of remaining contract value (25-50% of months remaining)
  • Flat fee specified in your contract ($500-$2,500)
  • Remaining monthly fees for the contract period (e.g., if 8 months remain at $300/month, you owe $2,400)

How to Verify: Review your contract’s “Early Termination” section or contact Tebra Billing Support with this specific question: “Does my contract include an early termination fee if I cancel before [contract end date]? If so, what is the fee amount?”

Data Retention Period: The 60-Day Window

Here’s the critical provision many practices miss:

Tebra retains your data for a minimum of 60 days after account termination as a safeguard.

What this means:

Grace Period: You have 60 days post-cancellation to retrieve any data you might have missed during your initial export.

Countdown Starts at Termination: The 60-day clock begins on your official cancellation effective date, not when you submit notice.

Example Timeline:

  • February 1: You submit 60-day cancellation notice
  • April 1: Your account officially terminates (last day of access)
  • April 2 - May 31: 60-day data retention period (you can request data exports)
  • June 1: Tebra may permanently delete your data

After 60 Days: Tebra is not obligated to retain your data and may permanently delete it from their servers. Data recovery after this point is typically impossible.

Critical Action: Export all data BEFORE your termination date. Use the 60-day retention period only as a backup safety net, not your primary export strategy.

The Cancellation Countdown: Your 90-Day Timeline

Here’s your complete action plan from decision to final termination.

Days 1-7: Pre-Cancellation Preparation

Before contacting Tebra, complete these essential steps:

Day 1: Review Your Contract

  • Locate your original Tebra/Kareo contract or order form
  • Document your required notice period (30, 60, or 90 days)
  • Identify any early termination fees
  • Note your current billing cycle and renewal date
  • Photograph or scan every page of your contract for records

Day 2: Calculate Your True Cancellation Costs Create a spreadsheet with these line items:

  • Current monthly cost: $_____ per provider × _____ providers = $_____/month
  • Notice period months required: _____ months × $= $
  • Early termination fee (if applicable): $_____
  • Total cancellation cost: $_____

Day 3: Audit Your Current Tebra Data Run these reports and document what data you have:

  • Total active patients: _____
  • Total patient encounters (last 12 months): _____
  • Outstanding claims (submitted but not paid): _____
  • Accounts receivable balance: $_____
  • Open appointments (future scheduled): _____
  • Clinical notes/documentation volume: _____

Day 4: Select and Evaluate New EMR If you haven’t already chosen a replacement, now is the time. Evaluate:

  • Migration support capabilities
  • Timeline from contract signing to go-live
  • Data import formats accepted
  • Cost comparison to current Tebra spend

Day 5: Request Data Export Capabilities Information Contact Tebra Support with this specific request:

“I am exploring options for data portability and need to understand Tebra’s data export capabilities. Please provide documentation on:

  1. What data can be exported (patient demographics, clinical notes, billing history, claims, etc.)
  2. Export file formats available (CSV, XML, HL7, CCD, PDF, etc.)
  3. Process for requesting bulk data exports
  4. Typical timeline for export file delivery
  5. Any fees associated with data exports”

This inquiry positions your question as “exploring portability” rather than announcing cancellation, which can sometimes result in more helpful responses.

Day 6: Backup Critical Data Externally Before announcing cancellation, create backups:

  • Export patient lists
  • Print/PDF outstanding A/R aging reports
  • Export pending claims reports
  • Download any custom form templates you created
  • Take screenshots of workflow configurations you want to replicate

Day 7: Plan Your Migration Timeline Work backward from your ideal go-live date with new EMR:

  • Go-live target date: [Date]
  • Minus 2-4 weeks for staff training: [Date]
  • Minus 2-3 weeks for data import and validation: [Date]
  • Minus 1-2 weeks for data export and cleanup: [Date]
  • Minus 60 days notice period: [Cancellation Notice Date]

This timeline shows you when you must submit cancellation to achieve your target go-live.

Days 8-14: Submit Official Cancellation Notice

Now you’re ready to formally cancel your Tebra account.

Step 1: Contact Tebra Support

Tebra doesn’t offer a self-service cancellation button. You must contact them directly:

Contact Methods:

  • Phone: Call Tebra Support (number available in your account under Settings > Support)
  • Email: Send cancellation request to your account manager or [email protected]
  • Support Ticket: Submit a ticket through your Tebra account under Help > Contact Support

Recommended: Use Multiple Channels: Call to initiate, then follow up with written email confirmation to create a paper trail.

Step 2: Cancellation Request Template

Use this written template (send via email for documentation):

Subject: Formal Cancellation Notice - [Your Practice Name] - Account #[Your Account Number]

Dear Tebra Support,

This email serves as formal notice of our intent to cancel our Tebra account effective [Target Termination Date - typically 60-90 days from today].

Account Details:

  • Practice Name: [Your Practice Name]
  • Account Number: [Your Account #]
  • Primary Contact: [Your Name]
  • Contract Start Date: [Original Contract Date]
  • Current Plan: [PM, EMR, Managed Billing, etc.]
  • Number of Providers: [#]

Cancellation Effective Date: [Specific Date - ensure this aligns with your contract notice requirement and billing cycle]

Data Export Request: Please provide instructions and access to export the following data before our termination date:

  • Complete patient demographics and registration data
  • All clinical documentation and chart notes
  • Billing transaction history
  • Claims history (submitted, paid, denied, pending)
  • Accounts receivable data
  • Appointment history
  • Custom templates and forms

Questions:

  1. Please confirm our cancellation effective date
  2. Please confirm if any early termination fees apply to our contract
  3. Please provide the data export procedure and estimated timeline
  4. Please confirm the 60-day data retention period following termination
  5. Will we have read-only access during the retention period, or must we request specific data exports?

Please acknowledge receipt of this cancellation notice and provide written confirmation of our termination date within 3 business days.

Thank you, [Your Name] [Title] [Practice Name] [Phone] [Email]

Step 3: Document Everything

  • Save a copy of your cancellation email with timestamp
  • If you called, document: date, time, representative name, confirmation number
  • Take a screenshot of any confirmation screens
  • Follow up in writing even if you canceled by phone

Step 4: Expect Retention Attempts Tebra’s account management team may contact you to:

  • Understand your reasons for leaving
  • Offer discounts or feature additions to retain you
  • Schedule a “cancellation interview”

How to Respond: Be polite but firm. If they offer meaningful concessions that address your pain points, consider them. But don’t be swayed by minor discounts if your core issues (reliability, features, cost structure) remain unresolved.

If you’re leaving due to persistent problems (outages, billing errors, poor support), document those issues in your cancellation reason. This feedback may help other practices, and in rare cases, may result in partial refunds or fee waivers if Tebra acknowledges service failures.

Days 15-45: Export and Migrate Your Data

You now have 30-60 days before termination. Use this time to systematically export and migrate data.

Week 1-2: Request and Download Data Exports

Follow Tebra’s data export procedures provided in response to your cancellation request.

Key Tebra Export Tools:

  • Reports Section: Export patient lists, appointment history, and financial reports as CSV
  • SFTP Access: Enterprise customers may have SFTP access for automated data transfers
  • API Access: Some integrations allow programmatic data extraction (requires technical expertise)
  • Manual Exports: Individual patient chart printouts (time-consuming but necessary if bulk export isn’t available)

Data Export Checklist:

  • Patient demographics (names, DOB, addresses, phones, emails, insurance)
  • Clinical documentation (progress notes, treatment plans, assessments)
  • Appointment history (past and future scheduled)
  • Billing transactions (charges, payments, adjustments)
  • Claims history (all claims with status and payment details)
  • Accounts Receivable aging report (outstanding patient and insurance balances)
  • Provider schedules and templates
  • Custom form templates
  • Procedure code lists and fee schedules

Week 3-4: Clean and Organize Exported Data

Before importing to your new EMR:

  • Standardize date formats (YYYY-MM-DD)
  • Clean phone numbers (remove formatting, ensure 10 digits)
  • Remove duplicate patient records
  • Validate insurance information completeness
  • Organize chart PDFs by patient (if bulk export produced individual files)

Week 5-6: Import to New EMR

  • Conduct test imports with 25-50 sample records
  • Validate data accuracy
  • Proceed with full import
  • Verify all critical records transferred correctly

Days 46-60: Parallel Operation and Transition

Continue Using Tebra During Transition: Don’t stop using Tebra immediately after data export. Continue normal operations until your new EMR is fully functional:

  • Document new appointments in both systems temporarily
  • Submit claims through Tebra until cutover date
  • Monitor claims already in process

Communicate with Patients: 2-3 weeks before your final Tebra cutover date, notify patients:

“Our practice is upgrading to a new patient management system on [date] to enhance your care experience. You may notice changes to our patient portal and appointment reminders. We’ll guide you through any new processes during your next visit.”

Train Your Staff:

  • Schedule 8-12 hours of training per staff member on new EMR
  • Create quick reference guides
  • Designate “super users” for each role (front desk, billing, clinical)

Days 61-90: Final Cutover and Tebra Shutdown

Pick Your Cutover Date: Choose a specific date (ideally a weekend or Monday morning) when you’ll:

  • Stop using Tebra for new activities
  • Start using new EMR exclusively
  • Maintain Tebra read-only access for reference

The Week Before Cutover:

  • Export one final update from Tebra (any data created since initial export)
  • Submit any pending claims through Tebra
  • Verify no appointments scheduled in Tebra beyond cutover date
  • Print final financial reports (A/R aging, YTD revenue, outstanding claims)

Cutover Day:

  • Staff meeting: “As of today, all new activity goes into [New EMR]. Tebra is read-only for reference.”
  • Update patient portal information
  • Update scheduling phone scripts
  • Switch appointment reminder system to new EMR

Post-Cutover (Days 1-30):

  • Maintain Tebra access for 60-90 days post-cutover
  • Reference Tebra for historical patient information
  • Monitor outstanding claims submitted through Tebra until all are resolved
  • Document any data gaps discovered during daily operations

Day 90+: Final Data Preservation and Tebra Termination

30 Days Before Data Retention Expiration:

  • Run one final complete export from Tebra
  • Verify you have backups of all critical data
  • Create a “Tebra Historical Records” folder on HIPAA-compliant encrypted storage
  • Document in your new EMR: “Records prior to [cutover date] archived from Tebra. Contact practice manager to retrieve.”

Verify Complete Data Access: Before your 60-day retention period expires:

  • Test opening archived files
  • Verify PDFs are readable
  • Confirm CSV files contain expected data
  • Store multiple backup copies (local encrypted drive + cloud storage)

Final Termination: Once you’re confident all data is safely exported and your new EMR is operating smoothly:

  • No action required - Tebra will automatically terminate access on your cancellation effective date
  • You’ll receive a final invoice for any outstanding balance
  • Tebra will permanently delete your data after the 60-day retention period

Handling Outstanding Claims During Transition

One of the most critical aspects of Tebra cancellation is managing claims already submitted but not yet paid.

Claims in Progress

30-90 Days Before Cutover:

  • Run a “Claims Status Report” showing all pending claims
  • Identify claims submitted but not yet paid
  • Document expected reimbursement amounts

Insurance claims can take 30-60 days to process. If you submit a claim on March 1st, payment might not arrive until April 15th - potentially after your Tebra access terminates.

Strategy 1: Maintain Tebra Access Until Claims Resolve

The safest approach:

  • Extend your Tebra access 30-60 days beyond your planned cutover date
  • Continue monitoring claims through Tebra until all are paid or resolved
  • Post payments received in Tebra during this period
  • Transfer final payment data to new EMR once claims close

Cost: 1-2 additional months of Tebra subscription fees Benefit: Zero risk of lost payments or claim tracking gaps

Strategy 2: Export Pending Claims and Track Manually

More economical but labor-intensive:

  • Export detailed pending claims report (patient, DOS, payer, amount, claim #, submission date)
  • Monitor claim status manually through payer websites
  • Enter payments directly into new EMR when received
  • Reconcile manually

Cost: Staff time for manual tracking Benefit: Cancel Tebra immediately, saving subscription fees

Managed Billing Service Termination

If you use Tebra/Kareo Managed Billing, termination has additional considerations:

Notice Requirement: Typically 60-90 days (check your contract)

Claims Run-Out Period: Tebra will continue processing claims submitted before termination and posting payments received within 60-90 days after termination (verify this with your contract).

Outstanding Patient Balances: Tebra will provide a final statement of accounts receivable. You’re responsible for collecting these balances after termination.

Percentage Fees: You’ll be charged Managed Billing percentage fees (typically 3-8% of collections) on all payments posted, even if received after your termination date.

Final Invoice: Expect a final invoice 60-90 days post-termination reconciling all payments received and final fees owed.

Federal and state laws mandate specific healthcare record retention periods:

Federal Requirements:

  • HIPAA: 6 years for privacy and security compliance documentation
  • Medicare: 7 years from date of service or 10 years for providers with cost reports

State Requirements (varies by state):

  • Adult medical records: 7-10 years from last treatment
  • Pediatric records: Until age 21-25 (varies by state)
  • Mental health records: Often longer retention (10+ years)
  • Billing records: 7-10 years

Your Tebra Data Export Must Include:

  • All patient records from at least the past 7 years (minimum)
  • Longer retention for pediatric and mental health records per your state
  • Financial records for 7-10 years
  • HIPAA compliance documentation

Storage Requirements:

  • HIPAA-compliant encrypted storage
  • Access controls and audit logs
  • Regular backup verification
  • Documented retention policy

Common Cancellation Pitfalls to Avoid

Pitfall #1: Canceling Before Exporting All Data Never cancel first, export later. Always complete data exports before submitting cancellation notice. Once your access terminates, recovering missed data is difficult or impossible.

Pitfall #2: Ignoring Contract Notice Requirements If your contract requires 60 days notice and you submit 30 days before desired termination, Tebra will hold you to the contract terms - you’ll pay for the extra month.

Pitfall #3: Assuming Data Export is Simple Tebra data exports, especially for clinical documentation, can be complex and time-consuming. Budget 4-6 weeks for comprehensive data export, not 3 days.

Pitfall #4: Not Maintaining Parallel Access Practices that immediately stop using Tebra after exporting data often discover gaps during daily operations. Maintain read access for 60-90 days.

Pitfall #5: Forgetting About Pending Claims Outstanding claims can represent tens of thousands of dollars. Don’t terminate Tebra access until all claims submitted through the platform are resolved and paid.

Pitfall #6: Poor Communication with Staff Staff members who discover mid-day that Tebra access disappeared create chaos. Over-communicate the transition timeline.

Pitfall #7: No Backup of Exported Data Always maintain multiple copies of your Tebra exports: local encrypted storage + cloud backup + offline archive. Hard drives fail.

Why Practices Leave Tebra/Kareo

As you navigate cancellation, it’s helpful to understand the broader context of why practices migrate away:

Cost Increases Post-PatientPop Merger: Many practices report subscription costs increasing 40-70% after Tebra’s formation from the Kareo-PatientPop merger, with features being unbundled into separate charges.

Reliability and Uptime Issues: Practices report frequent system outages affecting billing, scheduling, and patient access, with some experiencing 4-6 significant downtime incidents per quarter.

Enterprise Pivot: Tebra’s strategic shift toward larger practices has resulted in deprecation of features small practices depend on and support quality declining for smaller accounts.

Billing Complexity: The modular pricing structure makes it difficult to predict monthly costs, with hidden fees for features that should be standard (patient portal, telehealth, advanced reporting).

Better Alternatives Available: Modern competitors offer comparable or superior features at 30-50% lower cost with better reliability and migration support.

How Proactive Chart Welcomes Tebra Refugees

At Proactive Chart, we’ve helped dozens of practices successfully escape Tebra/Kareo contracts and migrate to our platform. Here’s how we make it easier:

Tebra Migration Specialists: Our team has mapped Tebra’s data structures and knows the common export challenges. We guide you through every step.

Flexible Timing: We coordinate our onboarding timeline with your Tebra cancellation notice period, so you’re ready to go live on your termination date.

Data Import Support: We help you clean, map, and import Tebra exports, including handling chart PDFs and historical billing data.

Transparent Pricing: No hidden fees, no modular pricing nightmares. You pay one predictable monthly fee that includes everything you need.

Better Reliability: Our infrastructure is built on enterprise-grade cloud hosting with 99.9% uptime SLA - we publish our uptime statistics monthly.

No Early Termination Fees: We don’t lock you into multi-year contracts with penalty fees. You stay because we earn your business daily, not because leaving is expensive.

Claims Management During Transition: We can help you track Tebra claims in-flight while establishing new claim workflows in Proactive Chart.

Your Tebra Cancellation Checklist

Here’s your complete action plan:

Pre-Cancellation (Week 1):

  • Review contract for notice period and early termination fees
  • Calculate total cancellation costs
  • Request data export capability documentation from Tebra
  • Audit current data volume
  • Select new EMR
  • Create migration timeline

Formal Cancellation (Week 2):

  • Submit written cancellation notice (email + phone)
  • Document confirmation and effective termination date
  • Request data export instructions
  • Schedule retention conversation (if desired)

Data Export Phase (Weeks 3-6):

  • Export patient demographics
  • Export clinical documentation
  • Export billing and claims data
  • Export A/R aging reports
  • Export appointment history
  • Create backup copies of all exports

Migration Phase (Weeks 7-10):

  • Clean exported data
  • Test import to new EMR (25-50 records)
  • Full data import
  • Validate data accuracy
  • Train staff on new EMR

Transition Phase (Weeks 11-12):

  • Run final Tebra exports
  • Pick cutover date
  • Communicate with patients
  • Execute cutover
  • Maintain parallel Tebra access for reference

Post-Termination (Weeks 13-20):

  • Monitor outstanding claims
  • Archive Tebra exports securely
  • Verify data retention compliance
  • Celebrate freedom from Tebra!

Ready to cancel Tebra and move to a better alternative? Schedule a cancellation strategy consultation with Proactive Chart. We’ll review your contract, help you plan your cancellation timeline, and show you how we’ll make your migration smooth and successful.

Tebra contracts end. Your practice’s success continues. Let’s make sure your transition preserves every patient record, protects your revenue cycle, and sets you up for growth with an EMR that actually serves small practices well.