Medi vs Practice Fusion

Short answer

Practice Fusion is a cloud-based ambulatory EHR for independent practices, now owned by Veradigm (formerly Allscripts, which acquired it in 2018 for $100 million). Its published price is $199 per provider per month on an annual commitment, and billing sits inside the clinical product rather than alongside it. Medi is the billing company's operating layer: $20 per client practice per month with volume pricing available as the book grows, no EHR or scheduling, and per-transaction EDI fees through Stedi. The two tools answer different questions. Practice Fusion answers what a practice runs on clinically. Medi answers what a billing company needs to manage a whole book of client practices. A third-party billing company does not chart, prescribe, or schedule; it submits claims, works denials, posts ERAs, and tracks A/R across many clients at once. Practice Fusion was built for the practice. Medi was built for the billing company.

Sources: practicefusion.com/pricing; Veradigm investor announcement

Choose Medi if billing is your business

Medi is built for billing companies that run revenue cycle work across multiple client practices. The fee is $20 per client practice per month, with volume pricing available. Adding providers inside a client practice never changes the fee; the rate moves only when you add or remove client practices, with volume pricing available as the book grows.

• Billing is the service your clients pay for, and they use their own EHR or do not need one from you
• Your team works cross-client denials, ERA review, and follow-up queues and needs those organized by function, not by client practice
• You want a fee that does not compound every time a client hires another provider
• You need aggregate A/R, denial volume, and collection rate across your whole book on one screen
• You want access controls that restrict an offshore posting team to four of your eight clients, not all of them
• You are paying per-provider seat fees today and want to know migration is free with a 12-month commitment, or $100 per practice (one-time, capped at $3,000) on a month-to-month basis

Choose Practice Fusion if the practice needs a low-cost, cloud-based EHR

Practice Fusion fits when the buyer is the practice itself, not a billing company. It is an ambulatory EHR for independent physicians who want cloud-based charting, ePrescribing, scheduling, lab integrations, and a patient portal in one system.

Choose Practice Fusion if:

• A small independent practice wants one vendor for clinical and administrative work and handles billing in-house
• The practice's primary need is charting, ePrescribing, and scheduling, not billing optimization
• A client of yours already runs Practice Fusion and switching its EHR would cause more disruption than the billing-platform difference justifies
• The practice wants to keep its vendor footprint minimal and is considering Practice Fusion's integrated billing service
• A per-provider price that bundles charting and scheduling alongside basic RCM is acceptable to the practice

Pricing model

Practice Fusion's per-provider price of $199/month is published at practicefusion.com/pricing and confirmed by multiple third-party review sources. Verify current pricing directly before making a budget decision, as pricing has changed over time.

Practice Fusion scales with provider headcount, not practice count: a book covering 20 providers is $3,980 a month in seat fees before add-ons. The two prices measure different things. Practice Fusion charges per seat for a clinical suite. Medi charges per client practice for a billing operating layer, so adding providers inside a practice never moves the fee.

Billing-company architecture vs practice-first EHR

Practice Fusion's primary tenant is the individual practice. Charting, ePrescribing, scheduling, and billing are all organized around that single practice context, and the billing features sit in the same environment as the clinical record. That helps a practice's own in-house billing staff, who can pull clinical context while working a denial.

For a third-party billing company managing ten unrelated client practices, the same coupling adds friction without payoff. The billing company does not chart and does not need an ePrescribing or scheduling module. It needs to see all ten practices' denials in one queue, post ERAs across clients in a single session, and track aging across the full book from one screen. Practice Fusion does not describe multi-practice billing-company features in its product documentation.

Medi starts from the billing company as the workspace, with each practice a scoped tenant inside it. A biller logs in once and works denials, ERA exceptions, and claim follow-up across every assigned client without switching contexts. Permission groups let an owner give a contractor access to three clients and not the other seven. The all-practices A/R view aggregates collection rate, denial volume, and aging across the whole book without opening each practice in turn.

Questions to probe in a side-by-side walkthrough:

• Where does cross-client denial routing live, and can a specialist work all clients' outstanding denials in one queue without manually filtering by practice?
• How does ERA posting review work for a billing company whose ERAs arrive across multiple payers and multiple client practices on the same day?
• What does aggregate A/R aging look like for an owner who wants a book-of-business view, not ten separate practice dashboards?
• How are access controls scoped when a posting team should see some clients but not others?

Claims, ERA, and billing depth

Practice Fusion's integrated billing service includes payer enrollment tools, claims scrubbing, same-day submission, insurance and patient payment posting, denial management, accounts receivable follow-up, and patient statement generation. Practice Fusion describes its billing team as drawing on "over 30 years of experience across 45+ specialties." The clearinghouse behind the service is not named in public product materials; verify it directly with Practice Fusion.

The architecture matters here: Practice Fusion's billing is a service layered on top of an EHR. The clinical encounter drives the workflow, charge entry flows from the visit, and the billing module assumes the charting system is also Practice Fusion's. A third-party billing company whose clients use different EHRs cannot bring those clinical contexts into a Practice Fusion billing environment that is not also each practice's EHR. The billing layer and the clinical layer are not separable products.

Medi routes all claim traffic through Stedi: 837P, 837I, 835, 270/271, 276/277, 278, and 277CA. The clearinghouse is not configurable - billing companies with existing clearinghouse relationships outside Stedi need to plan payer enrollment transition before cutover. ERA review in Medi surfaces held lines in a review queue with BPR check footer, CARC and RARC codes in plain English, and per-line decisions on one screen. PLB segments and recoupment adjustments appear as distinct entries rather than folded into the payment record.

Data, trust, and the 2020 DOJ settlement

Practice Fusion operates under Veradigm as a HIPAA-covered entity. Like any EHR vendor, it handles PHI under a BAA and is subject to the HIPAA Security and Privacy Rules.

One piece of trust context is worth knowing. In January 2020, Practice Fusion paid $145 million to resolve criminal and civil investigations by the U.S. Department of Justice. The DOJ found that Practice Fusion took kickbacks from a pharmaceutical company to design clinical decision support alerts that prompted physicians to prescribe extended-release opioids without regard for clinical appropriateness. It was the first criminal action brought against an EHR vendor under the Anti-Kickback Statute. The total was a $25.4 million criminal fine and forfeiture plus a $118.6 million civil settlement split between the federal government and participating states. Practice Fusion entered a deferred prosecution agreement and had to make related documents public.

Source: U.S. Department of Justice press release, January 27, 2020

This history matters for billing companies that weigh how a vendor has treated clinical decision support and data monetization. It predates Veradigm's current ownership, and the deferred prosecution agreement and compliance requirements imposed in 2020 are part of the public record. Evaluate it with that context in hand.

Is Medi always a better fit than Practice Fusion?

No. Practice Fusion is a reasonable choice when the buyer is the practice. A small independent physician practice that wants cloud-based charting, ePrescribing, scheduling, and a patient portal at a fixed per-provider price gets a single-vendor stack, and its integrated billing service is real. A practice that does not want to juggle separate EHR and billing vendors, and is not working through a third-party billing company, is served well.

The mismatch for billing companies is structural, not a feature gap. Practice Fusion is built for a practice running its own clinical and administrative operations. A billing company manages many client practices, does not chart, and needs cross-client visibility as its main workflow, and that is the operator Medi is built for and Practice Fusion is not.

Other comparisons billing companies look at

• Medi vs Tebra - another practice-first EHR and billing platform; per-provider pricing with a different support posture for billing companies
• Medi vs DrChrono - iPad-native and mobile-first EHR with a managed RCM tier for practices that want full billing outsourced to the EHR vendor
• Medi vs SimplePractice - behavioral health and therapy-focused platform with its own billing and scheduling layer
• Billing-company software evaluation guide - the criteria that matter when shortlisting across any practice-first or billing-company-first vendor
• Best Practice Fusion alternatives for billing companies — the full field of options beyond the head-to-head pages.

Frequently asked questions

Does Practice Fusion work for third-party billing companies managing multiple client practices?

Practice Fusion is designed around the individual practice as the primary user, and its billing service assumes that practice also runs its charting, scheduling, and ePrescribing in Practice Fusion. A third-party billing company whose clients use different EHRs cannot bring those clients into Practice Fusion's billing workflow without also adopting Practice Fusion as each practice's EHR. Practice Fusion does not describe multi-practice operator views, cross-client work queues, or billing-company access controls in its documentation. A billing company working across unrelated clients would be using a platform built for a different buyer.

Who owns Practice Fusion now?

Practice Fusion is owned by Veradigm, formerly known as Allscripts. Allscripts acquired Practice Fusion in January 2018 for approximately $100 million. Allscripts rebranded to Veradigm in January 2023. Practice Fusion operates as a distinct product brand within Veradigm's portfolio. Source: Veradigm investor relations.

What happened with the 2020 DOJ settlement?

In January 2020, Practice Fusion paid $145 million to resolve criminal and civil charges after the DOJ found it took kickbacks from a pharmaceutical company to design clinical decision support alerts that pushed physicians to prescribe extended-release opioids. It was the first criminal action against an EHR vendor. Practice Fusion entered a deferred prosecution agreement and agreed to disclose related documents. Full details are at the DOJ press release.

What does Practice Fusion cost?

Practice Fusion's published price is $199 per provider per month with an annual commitment, listed at practicefusion.com/pricing. That fee includes the EHR, scheduling, ePrescribing, lab integrations, patient portal, and access to Practice Fusion's integrated billing service. Pricing has changed over time. Practice Fusion was historically free to practices and monetized through pharmaceutical data agreements, a model it left before the 2018 acquisition. Verify current pricing directly before signing.

What clearinghouse does Practice Fusion use?

Practice Fusion's integrated billing service handles claim submission and ERA processing, but Practice Fusion does not publicly name the underlying clearinghouse. If you have specific payer-routing requirements or an existing clearinghouse relationship to transfer, confirm the clearinghouse, payer connections, and enrollment process directly with Practice Fusion before committing.

Can a billing company migrate client practices from Practice Fusion to Medi?

The challenge is that Practice Fusion is an EHR, so clinical and billing records are coupled. Moving billing workflows off it means separating the billing layer from the clinical layer, which takes coordination with the practice on data exports and on what it keeps using for charting. The lowest-disruption pattern: leave the last 60 to 90 days of in-progress claim work in Practice Fusion for legacy A/R collection, start Medi forward-only, and confirm payer enrollment and Stedi clearinghouse connections before cutover. On the Medi side, migration is free with a 12-month commitment, or $100 per practice (one-time, capped at $3,000) month to month; data export is always free with no early-termination fee. Verify export scope and exit terms in your Practice Fusion agreement first.

How current is this comparison?

Last reviewed 2026-06-07. Practice Fusion's pricing, product scope, and ownership details are subject to change. Primary sources: practicefusion.com/pricing for current pricing and product scope; investor.veradigm.com for ownership history; justice.gov for the 2020 settlement. Verify directly before making a budget or contract decision.