Medi vs Practice Fusion

Short answer

Practice Fusion, now owned by Veradigm (formerly Allscripts, which acquired Practice Fusion in 2018 for $100 million), is a cloud-based ambulatory EHR aimed at independent practices. Its published price is $199 per provider per month with an annual commitment; billing and RCM features are secondary to the clinical workflow. Medi is the billing company's operating layer: $20 per client practice per month with published volume discounts as the book grows, no EHR, no scheduling, and transparent per-transaction EDI fees through Stedi. The tenant split is the story. Practice Fusion asks "what does the practice run on clinically?" Medi asks "what does the billing company need to manage its entire 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 not designed for that shape of work, and no amount of configuration changes that. Medi was.

Sources: practicefusion.com/pricing; Veradigm investor announcement

Choose Medi if billing is your business

Medi is built for billing companies that manage revenue cycle work across multiple client practices. The fee is $20 per client practice per month, with published graduated volume discounts: $20 each for the first 25, $15 each for 26-50, and $10 each for 51 or more (graduated, so each tier applies only to practices in that band). Adding providers inside a client practice never changes the fee; the rate only moves when you add or remove client practices, and it falls 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 makes sense when the buyer is the practice itself, not a billing company. It is a well-established ambulatory EHR with genuine clinical depth 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 a single-vendor solution for clinical and administrative workflows and billing is handled in-house by a small team
• The practice's primary need is charting, ePrescribing, and scheduling rather than billing optimization
• Your billing company's client already uses Practice Fusion and migrating the EHR would cause more disruption than the billing platform difference justifies
• The practice is evaluating Practice Fusion's integrated billing services and wants to keep the vendor footprint minimal
• Cost is a dominant factor and the practice values a per-provider price that bundles scheduling and charting alongside basic RCM

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.

The arithmetic at twenty client practices: Medi's platform fee is $400 per month (20 practices at $20 each), plus EDI usage on top. At 25 practices the platform fee is $500; at 40 practices it is $725 (first 25 at $20, next 15 at $15); at 50 it is $875; at 70 it is $1,075. Practice Fusion at $199 per provider per month scales with provider headcount, not practice count; a 20-provider book at Practice Fusion is $3,980 per month in seat fees before add-ons. The gap reflects what each platform sells. Practice Fusion prices for a clinical software suite where per-seat licensing is the norm. Medi prices for a billing-company operating layer where adding providers inside a client practice should never change the fee.

Billing-company architecture vs practice-first EHR

Practice Fusion's primary tenant is the individual practice. Every workflow - charting, ePrescribing, scheduling, and billing - is organized around that single practice context. The billing features sit inside the same environment as the clinical record, which is useful for 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, that coupling creates friction without benefit. The billing company does not chart. The billing company does not need ePrescribing integration or a scheduling module. What it needs is a place 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. The practice is a scoped tenant inside that workspace. A biller logs in once and works denials, ERA exceptions, and claim follow-up across all assigned clients without switching contexts. Granular 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 every client without opening each practice individually.

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 billing service is not independently named in public product materials - verify directly with Practice Fusion.

The key architectural point is that Practice Fusion's billing is a service layered on top of an EHR. The clinical encounter drives the billing workflow. Charge entry flows from the visit, and the billing module assumes the charting infrastructure is also Practice Fusion's. A third-party billing company whose client practices use different EHRs cannot bring those clinical contexts into a Practice Fusion billing environment that is not also the 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 the Veradigm umbrella 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.

Trust context 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 solicited and received kickbacks from a pharmaceutical company to design clinical decision support alerts in its EHR that prompted physicians to prescribe extended-release opioids, without regard for clinical appropriateness. This was the first criminal action brought against an EHR vendor under the Anti-Kickback Statute. The $145 million included a $25.4 million criminal fine and forfeiture, and a $118.6 million civil settlement split between the federal government and participating states. Practice Fusion entered into a deferred prosecution agreement and was required to make documents related to the conduct publicly available.

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

This history is relevant for billing companies evaluating software where clinical decision support and data monetization practices matter. It does not reflect the current state of Practice Fusion under Veradigm's ownership, and the deferred prosecution agreement and compliance requirements imposed in 2020 are part of the public record. Evaluate 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, not the billing company. For a small independent physician practice that needs cloud-based charting, ePrescribing, scheduling, and a patient portal at a fixed per-provider price, Practice Fusion delivers a coherent single-vendor stack. Its billing service is real, and its team describes deep specialty coverage. A practice that does not want to manage separate EHR and billing software relationships, and is not working through a third-party billing company, will find Practice Fusion's integrated approach functional.

Where Practice Fusion does not fit the billing company use case is structural. Its product is designed for a practice running its own clinical and administrative operations. The billing company - which manages many client practices, does not chart, and needs cross-client visibility as its primary workflow - is not the buyer Practice Fusion built for. That mismatch does not change with feature configuration. Medi is built for the billing company as the primary operator. 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

Frequently asked questions

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

Practice Fusion's product is designed around the individual practice as the primary user. Its billing service assumes the practice is also running clinical workflows - charting, scheduling, ePrescribing - through 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 the practice EHR. Practice Fusion does not describe multi-practice billing-company operator views, cross-client work queues, or billing-company-specific access controls in its product documentation. A billing company working across unrelated client practices will find it is using a platform designed for a fundamentally 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. The DOJ found that Practice Fusion received kickbacks from a pharmaceutical company to design clinical decision support alerts that encouraged physicians to prescribe extended-release opioids. This was the first criminal action brought against an EHR vendor. Practice Fusion entered a deferred prosecution agreement and agreed to disclose related documents publicly. 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, as listed at practicefusion.com/pricing. That fee includes 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 moved away from 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 in its product documentation. Verify the clearinghouse, payer connections, and enrollment process directly with Practice Fusion before committing if you have specific payer routing requirements or existing clearinghouse relationships to transfer.

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

The practical challenge is that Practice Fusion is an EHR - clinical records and billing records are coupled. A billing company migrating billing workflows off Practice Fusion is separating the billing layer from the clinical layer, which may require coordination with the practice on data exports and on what the practice continues to use for charting. The billing-side migration pattern that limits disruption: leave the last sixty to ninety 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) on a month-to-month plan; data export is always free and there is no early-termination fee. Verify data export scope and any exit terms in your Practice Fusion agreement before beginning.

How current is this comparison?

Last reviewed 2026-06-03. 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.

---

For more on how Medi approaches multi-practice operations, see billing company operations and the software evaluation guide. For a parallel comparison against another EHR-bundled billing platform, see Medi vs DrChrono or Medi vs Tebra.