I currently use Medisoft with Gateway for electronic billing. Over the last four years we have spent an average of $75 per month for Medisoft support on a per incident basis. Gateway costs us $100 per month. As I understand it the AC-PM has more features than Medisoft but that's something I want to investigate further. As a solo doc $249/m is not much different from what I'm spending now. So at least for me, v8 with PM is worth exploring. I'm actually more concerned about whether the software is solid and whether support will be good than I am about the cost.