Steven,
I am using Quickbooks (pain in the neck)for account mgmt. and also use AC to print HCFA for only selective claims (mostly commercial ins.). Other than that I use Oklahoma Medicaid Website to submit claims (I wish all others would adopt that approach, it is very easy), use Medicare-Trailblazer's PC-ACE Pro32. BUT
Next in few weeks going to start Lytec 2009 as I got it for half the price you normally get.