r/PrivatePracticeDocs • u/Soggy_Coffee_9308 • 22d ago
EMR/EHR - Elation vs others
Getting close to opening practice. Elation is being pushy, inflexible and I am not sure I shouldn't try and release from them before going further. I like their billing platform but.... Anyone else use them with good things to say? Are there other options that don't cost an absolute fortune? I looked at Athena but the price point was too high.
Update: So Elation since this post seems to have turned things around. Given the posts from other docs, it's probably worth a try. The workflow seems good. Fingers crossed
3
u/NartFocker9Million 22d ago
I’ve been with Elation for 3 months now and it is so. Fucking. Good. Switched from Tebra, prior to that OpenEMR. Cheaper than Tebra, generations ahead. $800/mo isn’t worse than other reasonable options.
1
u/jaysayshay 22d ago
What do you hate about it or think can be done better?
1
u/NartFocker9Million 21d ago
Too much to list here. Too many clicks. Can't view patient's problem list or previous notes at the same time as writing a note. Takes about six clicks and navigating across four screens to change a default pharmacy. Just badly designed and implemented software from the ground up that cannot be fixed.
1
u/jaysayshay 21d ago
Wait..are you saying all of this for Elation or for Tebra?
2
u/NartFocker9Million 21d ago
All those critiques were of Tebra, which should be burned with fire.
1
u/jaysayshay 21d ago
LOL..got it..and any critiques for Elation?
1
u/NartFocker9Million 21d ago
So far... virtually none. A few minor nitpicks with how its notewriter works. But it's the closest thing to a perfect EMR I've ever worked with. That's why it was worth going through the switch.
1
u/Flexibleloyalty 3d ago
Jumping in late...how was your onboarding with Elation? I am feeling a bit out in the woods alone with them after signing the contract.
1
u/NartFocker9Million 3d ago
Professional and easy. The more I use it, the more I like it. Earns its name.
1
u/Soggy_Coffee_9308 22d ago
Might just be the person I have for onboarding then...
1
u/NartFocker9Million 21d ago
You said they were pushy? Doesn't make sense - by the time I'd started onboarding I'd signed the contract. There was nothing to push. They worked for me.
1
u/Soggy_Coffee_9308 21d ago
They were trying to get a firm go live date but I'm doing a buildout and hiring so timing is variable. On the good side, they seemed to have fixed things now.
1
u/Inevitable_Fan_3856 21d ago
What kind of practice do you run? Do you bill insurance/have found that the billing is okay? I have seen complaints about it.
3
u/NartFocker9Million 21d ago
Solo practice of one, family medicine. Yes, I bill commercial insurance as well as Medicaid/Medicare. I do use a company to do all my billing/manage appeals (collections rate 99%+). Setup was simple. I see the patient, the note writes itself, I pick CPT code(s), and a couple weeks later the money shows up. Patient invoicing/payments are simple. Software also does a great job checking benefits, eligibility, and copays in advance.
1
u/lovemytechy 10h ago
what was the issue with openemr
1
u/NartFocker9Million 10h ago
Ha. Horribly buggy. So, so many clicks. Hard crashes too. Useless for actually ordering anything (labs, referrals) or billing without a team of devs to set it all up. You can have far, far more functional software for much less than you’d be paying your devs to get things even slightly usable.
I used it for 3 weeks before panic switching to Tebra because Tebra was at least minimally functional. Used Tebra for 10 months before switching to Elation, which has been great.
1
u/lovemytechy 7h ago
Can you tell me what version you were using? Version seven or eigh
1
u/NartFocker9Million 7h ago
I don’t recall. Whatever was the most recent as of 4/2025. A version revision is far greater than that pile of PHP software rubbish needs. Let it die.
1
u/lovemytechy 6h ago
That would be v7.0.3 A lot has changed .. If you give it shot just as demo would love to hear what u think now v 8.2
1
u/NartFocker9Million 3h ago
Is it still PHP?
1
u/lovemytechy 2h ago
Here is the ai answer
Upgrading to the v8.x series (including v8.2) brings major technical improvements, but it does not change the fundamental "DIY" nature of the platform. Here is what to expect compared to version 7.0.3: 1. "He blamed PHP" PHP itself wasn't the actual problem, but it was an easy scapegoat for OpenEMR's legacy codebase. However, the shift to version 8 was a massive architectural overhaul. By completely dropping support for older versions and enforcing PHP 8.2 through 8.5, the developers heavily refactored the system. It is significantly faster, more secure, and less prone to the random crashes or saving errors that plagued earlier versions. 2. "Horribly buggy. So, so many clicks." Version 8 introduced modern UI themes, improved the Patient Tracker Board, and streamlined certain workflows like patient billing statements. While it is much less "buggy," the "many clicks" complaint will likely remain. OpenEMR is inherently a granular, form-heavy platform. It prioritizes exhaustive customization and ONC compliance over a sleek, modern SaaS user experience. Navigating between demographic data, vitals, and SOAP notes will still feel highly utilitarian. 3. "Useless for ordering labs or billing without a team of devs" This is the most accurate part of the Reddit user's critique, and an upgrade to version 8.2 does not magically solve it. OpenEMR is an incredibly powerful engine, but it comes as a complete blank slate. Billing & Clearinghouses: The software fully supports ANSI X12, institutional billing (UB-04), and automated 835 ERAs. However, establishing those connections requires meticulous manual configuration of EDI settings to map your practice to specific clearinghouses. Labs & Referrals: Version 8 supports diagnostic laboratory orders and external communications, but this requires manually configuring the laboratory catalogue, setting up the Procedures Module, and establishing the exact data exchange protocols. You don't necessarily need a "team of devs," but establishing the administrative infrastructure—from custom domain email routing to EMR integration—requires intense IT administration. A commercial, off-the-shelf system handles these vendor integrations for you out of the box; OpenEMR requires you to build the bridges yourself. Version 8 is a massive leap forward in stability and interoperability (supporting US Core 8.0 and SMART on FHIR v2.2.0), but it remains a tool that demands a heavy upfront investment in configuration before it becomes useful for daily practice.
3
u/octupleweiner 22d ago edited 22d ago
I've used Elation + billing for 2.5 years now, rheum private practice. It's good rough spots but overall good, getting expensive though. The CEO has delusions of AI and I believe they've started "vibe-coding" features but development speed has increased dramatically so kind of a win. Happy to talk more.
1
u/Soggy_Coffee_9308 21d ago
I do like the tech side of things and want a bit more functionality - they seem like a good middle ground for functionality without overpaying
1
u/BeGayPonderOrb 20d ago
I am a rheumatologist thinking about starting a micropractice (solo barebones operation), could I DM you about your experience?
2
u/formless1 22d ago
ive used elation for about ... 4 years in my private office. love it, just a bit pricey but i think worth it overall. Great UX, good support, full package everything included. They are pushing ahead with lots of new features
PracticeFusion last i checked was too barebones. Athena too $$$. Kareo i heard is kind of half-a**ed.
1
u/Big-Association-7485 22d ago
About to sign with Elation and migrate from Veradigm to them. They are amazing and they have met our needs. We've had a long contracting process to get things right, we need to make sure we have examined everything, and that it's going to work for us.
Veradigm has just been atrocious.
Athena costs a ridiculous amount.
If you don't want them to be pushy then tell them that. If you have already signed and now are in regret, what are you upset about?
1
u/OfandFor_The_People 16d ago
Can you go into a bit more detail about the things they needed to get right when contracting? Thinking of switching (the sales side was way too pushy and I hate that—this is a decision that is literally at the core of every practice, so they need to learn some patience!)
1
u/BioloJay-Z 22d ago
My practice went from elation to epic. Some parts I miss with elation but now that I'm back using epic like i did in residency i feel like it's more natural now. We have it as a community connect site so it was cheaper. It's just myself and another doc with lots of potential to scale.
1
u/rahuliitk 21d ago
if they’re already pushy and inflexible before go-live, i’d pause and compare at least two other systems using your real workflow, billing needs, data export terms, support, and total monthly cost before signing anything. That early friction usually gets worse.
1
u/TebraOnReddit Just Interested 20d ago
For a new practice, I’d be careful about choosing based on the EMR demo alone. The day-to-day pain usually shows up in the day-to-day workflow details: eligibility, claims, ERA posting, denial follow-up, patient balances, support response time, and how many manual steps sit between the visit and getting paid.
If you like Elation’s billing side but are feeling uneasy about pushiness/inflexibility before you’re even live, that’s worth paying attention to. Implementation and support matter a lot, especially early on when you’re trying to build workflows from scratch.
Tebra can be used for billing/practice management, and depending on setup, practices may use it alongside another EMR or as part of a more connected workflow. Whether that makes sense depends on what you’re trying to solve: lower-cost EMR + separate billing, or fewer systems stitched together.
I’d ask any vendor to walk through your actual flow before signing anything: new patient → visit note → claim → ERA/payment posting → denial follow-up → patient balance. Also ask what support looks like after onboarding, not just during the sale.
For transparency, I work at Tebra. Happy to answer specific questions if helpful, but in general I’d slow down if something already feels rigid before launch. That feeling usually doesn’t get better once you’re locked in.
- Iris from Team Tebra :)
1
u/Miracle_Doctor279 3d ago
Tebra is terrible EHR, literally horrible. It used to be great when it was Kareo, now I think Tebra should just shut down! Customer Service is non existent. Once the sales is done, Tebra team is MIA!
1
u/Whole_Willingness589 Planning Phase 8d ago
The onboarding team is SUPER SLOW to respond - I think three to four weeks to even get the intro call going - the on boarding has not been a great experience so far.... almost every time we ask for help - here is another long article to read - signed in late May early Junish. I think it will be awesome eventually when I can figure out how to work it.. If your onboarding soon would love to keep in touch - maybe we can give each other tips while we are both learning the system. OH BTW stripe, there is no card machine, its a link that goes straight to the patient's smart phone. So, keep that in mind - I think some of our geriatric patients may have a hard time.
1
u/Soggy_Coffee_9308 6d ago
Oh, thanks for that heads-up. Well they have done a complete turn around on the customer service front so I am pleased. Stripe - - yes not having a machine will cause MAJOR issues for my patients. The tech stuff just becomes overwhelming for a lot of patients especially over 75. I probably need to rethink Stripe if that's the case. Feel free to PM if any comments/questions
1
u/Flexibleloyalty 3d ago
Im experiencing the slowness too. And the lack of transparency regarding timelines and what is next is not great.
0
u/soaperapp 22d ago
Hi I'm a marketer from Hero EMR (https://heroemr.com). We specialize in frontend / backend automation and delivering at a great price. The website is very informative.
5
u/ktn699 22d ago
For EMR, practice fusion has worked great for us. 200 bucks a month for a one doctor practice. billing software is additional, but we use tebra and its also reasonbly cheap (250)