Tebra (Kareo) vs athenahealth vs eClinicalWorks

Kareo and PatientPop announced the closing of their merger, and the Tebra name, on 2 November 2021, and Tebra's pricing page now says 'Kareo is now part of Tebra.' Tebra describes itself as an all-in-one platform for clinical documentation, billing, payments, patient experience and practice growth, built for private practices. It prices per provider, not per user, and publishes monthly prices by provider type (see the pricing section below).

What Tebra says it offers, from its own September 2026 comparison page: a dedicated Onboarding Manager, with most practices live within 8 to 10 weeks; billing you can keep in-house, hand to a billing partner or outsource without a required RCM contract; patient-experience and marketing tools in the same platform, including review management and Google Business Profile optimization; and support for 50+ specialties. These are Tebra's statements about itself, not independent measurements.

Where Tebra's terms point to limits: its comparison page lists its supported practice size as solo to midsize and athenahealth's as small to enterprise, so ask Tebra how pricing and onboarding change at your provider count. Because the subscription is per provider, cost rises with each provider added. Tebra's pricing policy also lets it move an account from a subscription to a transactional plan after 30 days' notice once the account exceeds 500 claims per provider per month, and its pricing page lists add-ons such as EPCS setup and PDMP integration.

Our read: solo to midsize practices that want a per-provider subscription, a guided onboarding and billing they can keep in-house or outsource. If you already run on Tebra, see billing support inside a Tebra account.

athenahealth prices athenaOne as a percentage of collections: its Cost & Value page says the model 'corresponds to your organization's collections' and lists no rate, and its athenaOne page says 'Reach out for custom pricing', so any percentage you hear is a quote, not a published price.

What the percentage buys is set out in athenahealth's own service description (athenaOne Base, Summer 2026 edition, published 22 July 2026), which splits each athenaCollector service line into work athenahealth performs and work it marks 'Excluded, to be provided by Client'. athenahealth maintains the EDI interfaces that submit claims, makes claim-status follow-up calls and sends demand letters, researches certain denial types, and asks payers for reconsideration or formal appeal when it believes the payer erred. The practice keeps coding and charge entry, re-opening zero-paid lines under $200, calls about underpayments, and review of flagged claims denied over registration, onboarding or coding information the practice's staff entered and the payer found inaccurate. See which athenaCollector work stays with the practice for the full split.

athenaOne Base is athenaClinicals, athenaCollector and athenaCommunicator, and athenahealth is renaming its athenaNet platform to athenaOne. The service description says Global Rules are 'written by athenahealth and can apply to any and all clients across athenahealth's network', and names payer manuals and bulletins and Medicare's Correct Coding Initiative edits among their sources. Onboarding is fee-based: end-user training and go-live support are each offered for a fee that is 'typically a component of your onboarding fees', and Super User Training is priced at $2,500 per person.

Trade-offs: with no published rate, comparing cost depends on a written quote, and a percentage fee rises with collections. Our read: practices that want payer follow-up inside a percentage fee and can staff coding and charge entry themselves.

Ownership, as announced: in November 2021 athenahealth said it had agreed to be jointly acquired by affiliates of Bain Capital and Hellman & Friedman for $17 billion, with Veritas Capital and Evergreen Coast Capital each retaining a minority investment. We have not verified current ownership.

eClinicalWorks sells EHR and practice management on per-provider plans it publishes: EHR Only at $499 a month and EHR with Practice Management at $599 a month, each listed with no start-up costs. RCM as a Service is sold separately at 2.9% of practice collections (pricing page, read 1 October 2026; the pricing section below has the detail).

What eClinicalWorks states: initial training is included for practices with 1 to 9 providers; it will migrate data from an existing EHR to eClinicalWorks for free; and its site lists dental, vision, behavioral health, ambulatory surgery center and urgent care solutions. For claims, its partner page names Optum's Revenue Performance Advisor, TriZetto Provider Solutions and Waystar as clearinghouse partners. For working denials and A/R inside the platform, see working denials and A/R inside eClinicalWorks.

Trade-offs: implementation fees apply above nine providers, airfare is billed separately, and the pricing page lists fees per patient statement and per eClinicalMessenger transaction without a price. In 2017 eClinicalWorks and certain employees agreed to pay $155 million to resolve a Justice Department False Claims Act lawsuit (allegations only, with no determination of liability); the FAQ below gives the details. That is history, not a current rating.

Our read: practices that want a plain per-provider price for EHR or EHR with practice management, with RCM as its own 2.9% plan, and will confirm the fees that apply as the provider count passes nine.

The three vendors price in two main ways: per provider per month (Tebra and eClinicalWorks) or as a percentage of collections (athenahealth, and eClinicalWorks's RCM as a Service plan). Tebra and eClinicalWorks publish per-provider prices; athenahealth lists no rate. The vendor figures below were read from each vendor's own pages on 1 October 2026; the arithmetic is ours.

Tebra publishes per-provider monthly prices on its pricing-overview page and also returns a custom quote through its pricing form. It prices per provider, not per user: unlimited non-clinical staff use the platform at no extra cost (pricing page). At standard volume a physician provider is $599 a month on Practice Essentials (billing, clinical EHR and telehealth) and $799 on Practice Automation (which adds patient-experience tools); a non-physician provider (Tebra's examples include nurse practitioners and physician assistants) is $399 and $449, and a therapist $225 and $299. Practices submitting 100 claims or fewer a month can qualify for lower tiers (from $349 and $399 for physicians) and move to standard pricing after three consecutive months above that threshold. Single solutions start from $49 per provider per month for Patient Experience + Marketing (non-physician providers at practices submitting fewer than 100 claims a month); the EHR and billing starters, on the same under-100-claims basis, start at $99 for non-physician and $199 for physician providers. Tebra says exact cost depends on provider count, specialty, claim volume and bundle. Its own September 2026 comparison page cites subscription pricing from $49 to $799 per provider per month and says pricing is not based on a percentage of collections. Its pricing policy (last updated effective 1 July 2026) lists a one-time onboarding fee billed at sign-up without stating an amount. Add-ons its pricing page lists include EPCS setup at about $75 per provider one time and PDMP integration at $500 one time per facility plus about $50 per user a year.

athenahealth prices athenaOne as a percentage of collections. Its Cost & Value page says the model 'corresponds to your organization's collections' and lists no rate, so any percentage you hear is a quote, not a published price. Onboarding is fee-based: its service description says end-user training and go-live support are each offered for a fee that is 'typically a component of your onboarding fees', and lists Super User Training at $2,500 per person.

eClinicalWorks publishes three plans on its pricing page: EHR Only at $499 per provider per month, EHR with Practice Management at $599 per provider per month, and RCM as a Service at 2.9% of practice collections, each listed with no start-up costs. Initial training is included for practices with 1 to 9 providers; additional implementation fees apply above nine providers, airfare is billed separately, and fees apply per patient statement and per eClinicalMessenger transaction without a price on the page. Six providers on EHR with Practice Management is $43,128 a year in subscription ($599 x 12 x 6) before those fees. Percentage-of-collections pricing is therefore not unique to athenahealth. RCM as a Service is listed as its own plan, so we do not add it to the per-provider subscriptions in any arithmetic here.

A percentage fee equals a flat monthly fee when annual collections per provider equal twelve times the monthly fee divided by the percentage. For a $599 per provider monthly subscription ($7,188 a year), a 4% fee costs the same at $179,700 of collections per provider, a 6% fee at $119,800 and an 8% fee at $89,850. Below those levels the percentage costs less than the subscription; above them it costs more. The $599 figure is both Tebra's published Practice Essentials price for a physician at standard volume and eClinicalWorks's published price for EHR with Practice Management; the scopes differ, so treat it as an arithmetic example, not a like-for-like pairing. These rates are illustrations, not quotes: athenahealth lists none. See how percentage and per-claim fees compare for the billing-service version of this arithmetic.

The comparison is not apples-to-apples. A per-provider subscription buys software, while athenahealth's percentage also buys the A/R follow-up and denial work its service description assigns to athenahealth, and eClinicalWorks sells that kind of work as its separate 2.9% plan. Whether the three land close together or far apart depends on which services you normalize and at what collections volume, so run the arithmetic on your own collections rather than trusting any headline rate, including the ones above.

Tebra vs athenahealth is mainly a pricing-model and scope decision. Tebra is a per-provider subscription with published prices by provider type and volume tier, a dedicated Onboarding Manager and, by Tebra's comparison page, go-live within 8 to 10 weeks for most practices; it requires no RCM contract, so billing work stays with you, a billing partner or an outsourcer. athenahealth charges a percentage of collections, lists no rate, and its service description assigns claim-status follow-up and payer appeals (where it believes the payer erred) to athenahealth, and coding, charge entry and review of flagged denials caused by inaccurate practice-entered data to the practice.

The break-even logic follows from that structure. Below a certain level of collections per provider a percentage fee costs less than a flat subscription, and above it the subscription costs less (the pricing section above gives the levels for a $599 fee). But a percentage fee is also buying revenue-cycle labor, not just software, so the comparison has to normalize for service scope. For the flagged denials that stay with the practice, see focused denial work.

Our read: choose Tebra if you are a solo to midsize practice, want a per-provider subscription and are comfortable owning billing operations or outsourcing them separately. Choose athenahealth if you want payer follow-up and appeals inside the platform contract, can staff coding and charge entry, and hold a written quote that makes sense at your collections.

Tebra vs eClinicalWorks compares two per-provider subscriptions that both publish prices. eClinicalWorks lists $499 for EHR Only and $599 for EHR with Practice Management per provider per month, each with no start-up costs. Tebra lists $599 for a physician at standard volume on Practice Essentials (billing, clinical EHR and telehealth) and $799 on Practice Automation, with lower prices for non-physician providers, therapists and low-volume practices, so the gap between them depends on which Tebra bundle, provider type and claim volume you compare.

Onboarding differs too. Tebra's comparison page says most practices go live within 8 to 10 weeks, guided by a dedicated Onboarding Manager. eClinicalWorks's pricing page states no go-live time; it includes initial training for 1 to 9 providers and charges implementation fees above nine.

Our read: choose Tebra if you are a solo to midsize practice that wants pricing built around your own provider type and claim volume and a guided onboarding. Choose eClinicalWorks if you want a plain per-provider price for EHR or EHR with practice management and will confirm the fees that apply as your provider count passes nine.

Walk through the decision factors that matter in selection. What follows is our read, anchored to what each vendor states.

Practice size: Tebra's comparison page lists its supported practice size as solo to midsize. eClinicalWorks includes initial training for 1 to 9 providers and charges implementation fees above nine. athenahealth offers Bootcamp onboarding to organizations with 5 or fewer providers and up to 30 staff. Those are vendor terms, not rankings: ask each vendor how pricing and onboarding change at your provider count.

Specialty: Tebra says it supports 50+ specialties, eClinicalWorks's site lists dental, vision, behavioral health, ambulatory surgery center and urgent care solutions, and athenahealth's service description says it maintains a library of specialty-specific clinical documentation templates. Specialty-deep practices should also look at specialty platforms such as Modernizing Medicine or TherapyNotes before defaulting to one of these three.

Pricing model: a per-provider subscription (Tebra, or eClinicalWorks's EHR plans) does not rise with collections the way a percentage does, though Tebra's tiers vary with claim volume, while a percentage of collections (athenahealth, or eClinicalWorks's RCM plan) moves with them. The break-even arithmetic in the pricing section shows where they cross.

Billing work inside the fee: practices that want the vendor to work claim-status follow-up and appeals lean toward athenahealth or eClinicalWorks's RCM as a Service; practices running their own billing, or using a separate billing service, lean toward the per-provider plans. Integrated versus standalone billing is its own decision, covered in the related comparisons below.

Implementation timing: of the vendor pages read, only Tebra's pages state a go-live time (its comparison page says 8 to 10 weeks for most practices; its onboarding page says most customers begin using the platform within 45 days). eClinicalWorks and athenahealth state none, so ask each for a dated project plan before you commit to a go-live date.

Long-term scaling: ask each vendor how cost changes as you add providers. Tebra adds a subscription per provider, eClinicalWorks adds $499 or $599 per provider per month and implementation fees above nine providers, and athenahealth's percentage rises with collections.

As an outsourced billing service, MedPrecision works inside the practice's own platform rather than asking it to switch. On athenahealth, we staff the athenaCollector work the service description leaves with the practice (athenahealth billing support). On eClinicalWorks, we work claims, denials and A/R inside the practice's eCW instance, and RCM as a Service is eClinicalWorks's own 2.9% plan, so an outside service is an alternative to it (eClinicalWorks billing support). On Tebra, we work claims, denials and A/R inside the practice's existing Kareo/Tebra login, and Tebra says billing can stay in-house or go to a partner or outsourced service without a required RCM contract (Kareo/Tebra billing support). The platform shapes the operating details, not whether outsourced billing fits: see the platform-vs-billing-service decision. For our own fees, see MedPrecision's published pricing.