The program record your state requires, the private health record HIPAA protects, and payment — insurance billing, credentialing, and superbills — on top of them. The records work on their own. Payment is optional, always.
One system that holds everything your state's program requires — New Mexico's Medical Psilocybin Program, Oregon psilocybin services, Colorado natural medicine — hosted under a BAA — the signed agreement HIPAA requires to protect health data — and kept apart from your health and billing records. It is live and in use in practices today.
New Mexico's 7.35.3 NMAC record with DOH submission packets. Oregon's OAR 333-333 service-center record with the quarterly aggregate report. Colorado's 4 CCR 755-1 facilitation record with the de-identified state report. Registration, medicine tracking, safety-report deadlines, and the state reports come straight out of the record — not assembled in a scramble when the deadline hits.
Consent, screening, and prep forms go to patients through a secure portal with typed e-signature. No paper packets, no scanned PDFs to chase down.
The state and a payer need to see different things. The record keeps them separate by default: program content never reaches a claim, and everything works the same whether or not you bill insurance.
Each practice gets its own login and its own walled-off record, hosted on Google Cloud under a Google Workspace BAA. Downstream hosts it and has no access unless invited in. Telehealth sessions run through Zoom under a BAA.
Set up for FDA-approved psychedelic medicines, too. When they arrive, they'll chart on the clinical side and bill like any other treatment — in the same system, next to your state program. Healing centers will likely offer both; you won't need two record systems to do it.
The other half of the two-records problem. Care you give under your own license — intake, screening, therapy — goes in its own private health record. It sits beside the program record and never mixes with it. This is the HIPAA side of the house, and the only side an insurance company ever sees.
Clinical notes include what billing actually needs — diagnosis, session times, location, insurance — in standard clinical language. Once a note is signed it can't be quietly changed; later edits are added on top. That way the record holds up if anyone ever reviews it.
Each practice's record is walled off and hosted under a BAA, with telehealth through Zoom under a BAA. Every change to the record leaves an audit trail.
Optional, and it runs on top of the records. Screening, prep, and integration bill as ordinary psychotherapy under Medicaid and commercial plans today. How billing works →
Credentialing means getting approved by insurance plans so you can bill them. It takes months of forms and follow-up calls, so we start before your doors open. You send one packet of documents; we handle the rest — Medicaid enrollment, plan applications, and contracts.
You send us visit records. We check each patient's coverage, send the claims, track the payments, and fight denials. Software drafts the paperwork; a person approves every claim. Launches in New Mexico in December 2026.
Skip insurance entirely. Patients get a superbill — a receipt with the correct insurance codes — for screening, prep, and integration visits, and send it to their own plan to get money back. No credentialing, no claims, no insurance contracts.
Record system pricing is set per practice on an initial call. Billing is priced separately: a flat credentialing fee up front, then a percentage of what Downstream collects. A practice that uses only the record system pays no billing fees. Book a call to get a quote.
All three. New Mexico's Medical Psilocybin Program under 7.35.3 NMAC, including the 7.35.3.8 patient application and the 7.35.3.13.C administration-day report. Oregon psilocybin services under OAR 333-333, built for service centers, including the quarterly aggregate report. Colorado natural medicine under 4 CCR 755-1, including the de-identified state report. Each practice's record uses its own state's fields, checks, reports, and terms.
Yes. Program and compliance data are kept separate from the clinical and payer-facing record by default. DOH submission packets are built from the program record. Program content never reaches an insurance claim; only the visit data required to bill a service correctly crosses over, and only when the practice bills through Downstream.
Pick a time that works, tell us where you practice and what you're interested in — record system, billing, superbills — and we'll take it from there.
Book a call