using OA now and it's not too hard to use (it's still in development as well), but unfortunately, i'm having to keep 2 databases-one for OA w/ the insurance info and another in AC w/ pt encounter info--have not seen any integration between the two yet. also, as for costs, oa is pretty reasonable if you want to mail the cms1500 yourself (cost of paper and stamp)--you can print out filled out forms w/ oa's pm.