I use TotalMD. It has an HL7 interface with AC. It can go both ways but I set it to AC into TMD only. Once it's set up and you understand the kinks, it's been seamless. (For example, the insurance address has to match perfectly, otherwise duplicate insurances will be created.) We bought the software version years ago so I don't remember the cost. But now, we are on a $139/month plan that includes upgrades and support. This doesn't include the clearinghouse. For that we use Availity and it's $213/month (I have advanced claims editing features).

Serene
Office Manager
General Pediatrics
Houston, Texas