I am using OA to send claims. I still use my previous PM program as a PM program. Duplicate work but good results. OA has been nearly flawless. The most it has cost me was $19/month because I do send a lot of Medicare claims. They otherwise use a free clearinghouse. I am not sure its ability to produce reports and practice analysis is quite sufficient but I use my PM program for that. But, in all honesty I have not really tried OA in all it's various modes. I have looked into the patient portal and I have set up an account but really do not use it. I do however think it would meet the Medicare guidelines. If I were to leave AC, I believe this is where I would look. I would suggest you simply try a few patients, start to finish and see how it works for you. It is too bad AC could not have gotten together with OA to make a complete package for both. OA will never be the EHR that AC is and AC will never be the PM that OA is.