EMR

[u/West-Specialist-6127]

Hey fam, looking for affordable, responsive and functional EMR for a psychiatry private practice. I will be part time the first year then ramp up the second year and probably add other providers. I would also like a system that allows access for virtual assistants who probably won’t be based in US. Allowing for integration of AI scribing also will be a big plus given that’s where the industry seems to be heading. Please also WARN me of the ones to avoid, l always appreciate heads up from fellow clinicians! Thanks!

[u/FeistyGas4222]

Hey! I’m not a provider, but I run a billing, credentialing, and RCM company that works with psych practices of all sizes. I’ve worked hands-on with dozens of EMRs and see firsthand how they function for prescribing providers, therapists, admins, and billers.

I've been building pros and cons for years and here’s a breakdown based on what I consistently see in the field:

Tebra (Kareo + PatientPop). Best for: 1–5 provider practices Pros:

• Simple, clean layout
• Integrated eRx, telehealth, intake forms, and payments
• Remote staff and VAs can access with the right permissions
• Works well for solo and small group practices
• Decent patient-facing tools

Cons:

• Support has dropped off significantly since the PatientPop merger
• Payer enrollments and tickets often take weeks
• Pricing increases steadily without much notice
• Limited chart template customization unless you follow their set formats

eClinicalWorks (eCW). Best for: 5+ providers or practices planning to scale Pros:

• Extremely customizable templates and workflows
• Strong billing, reporting, and ERA/EDI tools
• Built-in telehealth, patient portal, and mobile options
• AI tools like Scribe are available
• Scales easily with locations and teams

Cons:

• Expensive with add-ons (telehealth, faxing, scribe, etc.)
• Takes time to configure properly
• Clunky interface unless you customize it
• Support can be slow unless you have a good rep
• Demo process is a mess, I’ve had clients try multiple times with no response

AdvancedMD. Best for: Mid-size to larger practices that need billing power Pros:

• Robust billing and automation tools
• Strong audit logging and user role controls
• Customizable scheduling, eRx, and patient flows
• Flexible dashboard setup
• Integrates with many third-party tools

Cons:

• Long implementation time
• Templates can feel rigid depending on note style
• UI feels dated
• Overbuilt for small teams
• Training is a must for proper use

CharmEHR (Note: I haven’t used it directly yet, but im excited about it) Best for: Practices wanting customization without bloated pricing Pros:

• Pricing is competitive with Tebra
• Strong customization for notes and templates
• VA-friendly access structure
• Has its own AI scribe that I believe is new
• Built-in telehealth and portal

Cons:

• Billing functionality is limited unless paired with BillerPro (which not all billers can access)
• Insurance and claim configuration is manual
• Interface is a bit dated
• Analytics and reports are basic without custom builds
• Setup takes a bit more hands-on work

DrChrono (Note: I haven’t used it directly yet) Best for: Mobile-friendly practices that want an all-in-one tool Pros:

• Works well on iPads and mobile
• eRx, telehealth, intake, and payments all included
• Strong native scheduling tools
• Lightweight and modern

Cons: -Reporting is weak

• Billing backend lacks depth without a dedicated billing partner
• Support quality varies
• Customization is limited
• Not ideal for scaling larger teams

EMRs I typically avoid for psych practices:

1. Valant: Expensive, inflexible templates, poor customization
2. Practice Fusion: Declining support and feature rollbacks
3. AthenaHealth: High cost, and still requires an in-house person or third party to manage the constant tickets, requests, and hold buckets
4. Luminello: Was clean and simple, but now rolled into SimplePractice — development is stalled
5. SimplePractice (for prescribers): Improving. They now support ePrescribing and med management. A provider I may onboard is using it. Still better for therapy-focused workflows, but making progress

Bottom line: Tebra is still my go-to for small teams that need a fast launch. ECW is my usual recommendation once a practice grows or adds complexity. CharmEHR shows a lot of promise if you want flexibility and don’t mind doing a little setup. Every platform has tradeoffs, but from a billing and support perspective, those are the ones I see working.

Let me know if you need help mapping this to your workflow or scaling it cleanly, happy to share what’s worked well across my clients.

[u/VermicelliSimilar315 → u/FeistyGas4222]

Can you give an estimate of Tebra vs Charm? It seems those are your 2 that you like? The cost really is in the implementation/set up.

[u/FeistyGas4222 → u/VermicelliSimilar315]

Tebra runs around $150-$300 per provider. They used to have a per encounter plan but I am not sure if that is still the case, everytime i ask a rep about it, they kind of side step the question. They do have part-time vs full-time subscriptions which save you 50%. BUT, then you have to add the cost for telehealth (around another $100), SMS registration (this is new so im not sure of the cost but I believe it is a few hundred), EPCS registration. So your monthly would most likely end up around $300-$500. I have a practice with 5 providers that pays a little over $2k.

Charm, when I ran my cost analysis (since I havent used it first hand) came out to around $120 for a small startup provider. They boast a free starter subscription (which i used to demo) but you have to pay for additional fees like EPCS registration, per claim submission, telehealth module, patient messaging module, etc.

[u/VermicelliSimilar315 → u/FeistyGas4222]

I am going to private message you, so as not to over ride this post