Home Forums Discussions General Discussion Credit card renewal......

I'm just curious if anyone else has experienced this. We were told when the rates went up our fee would not change as long as we used the same card. My Assistant even asked the what if question ie the card was stolen, we were told yes then your rate per year will go up.

Of course the unthinkable has happened, my truck was broken into and my purse stolen. The police have actually recovered it but not before he used the cards and we had to cancel everything. My renewal happened to come up this month so.... We were paying $850 it is now $1990! Amazing charts told me there is nothing they can do they are sorry that it was stolen but that is the way it is. It was suggested to email Jon which I have but no response yet. I realize it is still an awesome package at 1990 but for a solo practitioner to go up to that from $850 was a big pill to swallow especially as it was not my fault the card number had to change.

Had the same experience. Not very pleased. Seriously thinking about Practice Fusion.

I was worried about the same issue. I added a new card to my account so I could "retire" the one my AC charge goes to. Luckily it is a no fee bank card. Just sits in the drawer waiting for the yearly AC charge.

Alexis,

Not saying it is wrong or right to post here, just giving some input based on seven years of being on the boards. You will have way better luck emailing (even if he hasn't returned your email) and/or calling him. Talking directly to Jon is the best way to get things changed back.

On the other hand, posting the issue here is the worst way. I completely understand your frustration. Just an opinion.

I'm sorry I've not gotten back to you yet, Alexis. We are in the final process of beta-testing V6 and I've been focused on this and our Practice Management module development (the current status of which is here).

Your concern is certainly understandable and warrants a response, especially since it is an example of a good intention gone wrong. Let me explain:

As noted, we are working to move V6 to general release. V6 is ONC-ATCB certified for Meaningful Use, or as it might be described, "government approved as a complete EHR." To get this certification cost us over $40,000 - and that was just to take the test! It doesn't include the actual cost to design, add the many requirements, test, support, and continually improve the program so it continues to meet the ongoing needs of our clients. And just like my home expenses go up (cable bill, phone bill, healthcare insurance premiums), so too do the company's.

Yet unlike other EHRs that continue to charge hundreds to thousands each and every month (or will instead sell your practice information to insurers, advertisers, and whoever else is willing to pay), we charge our clients enough to cover our expenses, plus a bit more. And most of the "bit more" goes back into further improving our software and the company. Not to shareholders or VC-backed playboys flying around in private jets. In other words, Amazing charts philosophy is to treat our customers fairly. No price gouging, surprise fees, or selling your information to others.

Of course part of being fair to our clients (and our own staff), is to not go out of business. In other words, we need to charge enough to cover our expenses, and then make a reasonable profit for further R&D and company growth. This means that our price must go up from time to time. And in our quest to raise prices fairly, we decided that rather than just have our price increase occur with the next bill (as is done by nearly everybody else), we would handle our price increase in a ?kinder? way: we decided that when our price increased, anybody whose credit card automatically rebilled without requiring any intervention would just get charged what they had paid the year before - even if our expenses were higher.

Since all credit cards expire at some point, or get changed, or lost, (or stolen), we decided that no matter the reason, as long as no staff time was required the automatically rebilling price would be allowed to go through without the increase to our current price. This was us trying to be "fair? to our existing clients, but also to our company ? since the price has to increase if expenses increase.

The reality is that so long as that client?s card rebills automatically at the old price, Amazing Charts is technically losing money having them as a client. It's not a lot of money, and based on our company?s philosophy, it seemed like a reasonable "business expense" to be able to provide this extra-ordinary level of fairness - so fair, in fact, that the client wouldn't have to ask for it, or even know it was happening in the first place. Which, I suspect, is why you are frustrated rather than thankful.

Based on this approach, in fact, your practice has actually been paying the same pricing you paid in 2008. At that time our maintenance & support was $500 for the first provider, $100 each additional Provider, and $250 for OffSite Backup which equals $850. (Adding ePrescribing should have cost you an additional $420 per provider but we stopped charging extra for this as it seemed wrong that providers would have to pay for the privilege of ePrescribing). In other words, because your card has automatically rebilled over the last four years, your two provider practice has been paying $850/year instead of the $1250/year you should have paid since 2009, and what those who purchased after December 1, 2010 currently pay: $2045/year for two providers and Offsite Backup.

While this may not seem fair to those who purchased more recently, it was our attempt at showing our gratitude to loyal customers who ?trusted? us with their EHR needs before we were certified or had various features that have since been added ? and are still being added.

Our good intentions and underlying philosophy of always striving to be fair have clearly backfired. So I?m not sure how to proceed at this point. It seems that it is time to change our approach, and avoid the irony that acting in good faith leads to anger and frustration in the very people who?ve benefited from our approach. My sense is that we need to simply get rid of this approach ? or do a better job of explaining it (although we?ve tried on the site where you buy Amazing Charts as well as in our user agreement (EULA) ? see paragraph 4).

I'm sure we'll discuss this in more detail at our Users Conference, but what do others think?

I think the strategy has been more than fair, and I for one am thankful for it. We were given appropriate advance notice and had the chance to renew put the charges on a card with the furthest expiration date to maximize savings.
I think it is a case of not realizing the good fortune of this policy of being so fair, and therefore not appreciating it... and misdirecting the frustration of bad luck (lost/stolen card) toward a criticism of a more-than-fair policy. We humans are often quick to complain, but slow to thank/praise.
So, thanks Jon. Your policies are much appreciated.

I guess there are several things at work at the same time.

On the negative, rates have climbed faster than "inflation," (a nebulous term in the EHR industry since everything is up for grabs with the infusion of Federal Money.) Much of this is due to the growth of AC into a more robust corporation with larger staff and trying to meet Federal guidelines. In short, to get you money back.

The positive is that Jon has, in the past, tried to keep prices fair. One of the selling points of AC is a fair price. Yes, but the price has increased a fair bit in the last few years. If you are not getting stimulus money then this is a fairly big hit to a small practice. In the example above this is going from $850 to $2045. Ouch.

Overall V6 is not THAT different from V4 (it's better, but...) BUT e-prescribing alone makes all the difference in the world and previously was about $40/mo (Jon states $420 for the year above.) It's inclusion in AC5 and above makes it all worth it. In the above example (using Jon's #'s) that then makes it $850+$840 (2 prescribers) or $1890. Not a lot different from $2045 ($155).

IT'S INCLUSION IS NEEDED FOR MEANINGFUL USE. Even if it wasn't, it is a great addition. I do have issues with having to pay $40/mo to prescribe but this is again one of those hidden mandates to improve quality. Not as big of a deal if you actually get money from the feds.

Personally, I would prefer to keep my credit card alive and pay less but realistically, I understand the need for the company to economically survive.

So what's my take? I thank Jon for keeping the price reasonable, but keep the company afloat. I don't think his intentions have backfired, they point out how fair he has been and the reality of running a growing company in a changing market. I would like him to keep the current policy in place. Eventually everyone will catch up, just a little slower.

(as an aside, someone in another thread commented about thinking about switching to practice fusion. it will cost $1200 a year to get rid of the advertising. It is truly an inferior product. Did they ever get meaningful use certified?)

I for one did not understand the rationale for the policy, and now am wiser, after stumbling this thread and read Jon's explanation. Thank you Jon for taking a hit while giving us longer-term users a break.

On a related note, I see that my profile no longer has an updatable credit card. I presume that's so I cannot change the card I am automatically billed on.

When I bought AC late last year, I also did not understand this credit card policy. However, at that time, there was also an offer to pre-pay for 2 years of support before the price increase. With Jon B's help, I was able to do that. I think it is much simpler and clearer to make such an offer to existing users before a price increase, rather than to track the credit cards. This allows AC to generate a cash infusion if needed for development, and gives each user a choice about the renewal price in a clear way. Although there are certain things that are a bit "rough around the edges" with AC, I appreciate the fact the Jon B. is so involved, and responsive and fair to users. When I was shopping for an EMR, I found no other company that operated this way. I hope we do not wear him out. We all have a vested interest in the success of AC.

I appreciate Jon Bertman's frank discussion of this situation. As a first year user of the program back in like 2002 I paid $250 once and $250/yr for updates. Can you believe that? Now the program is much more complex and has many more "hoops" to jump through for meaningless use. I understand and support the price increases. Prior to 2002 I was using an EMR that went under. Believe me - that is no fun. $250 a year just can't support all the crap Jon's company has to do. Without certification, that is the death nail for the company. He had to do it.

The credit card update policy is strange but I view it as a bonus if I get a discount. However, others may feel after they get their credit card stolen double victimization. Once Jon gets this V6 out the door, I would suggest moving on to a system where email is sent out saying, prices are going up next year, if you want to renew at the old rate do so in the next month" just to make things clearer.

Well, never one to not have an opinion, I am and always have been in favor of not having the "keep your credit card active and keep the same price" policy.

I think it is fair, more straightforward, and makes more sense to have a cost for the program and, if you don't have a credit card to pay for it with, you don't keep AC. My sense is over 95% of users would continue to pay.

If you use the theory that one's keeping a credit card active costs the company less when renewal time comes, then you certainly have to make exceptions to someone who actually loses their card.

Again, my vote would be to do away with this well intentions but impossible to do fairly system.

The method suggested of paying early has some merit but does not reward those who have used the program longer. If you wish to do this, then have the same charges for everyone, but give graded discounts based on length of use.

So, that is my three cents.

Bert, your comments confuse me. I was under the impression that this price increase/credit card issue was more of "the price is going up, and to ease the burden on our current users, you can keep your current price until AC office needs to do something on their end, like enter new billing info when you get a new card number (for whatever reason that is) But eventually you too will be paying the higher price in time." I thought this was a great plan, giving current users a price-break for a short time. The alternative was just to say, "the price is going up, and when you are up for renewal, you will need to pay the higher price to keep AC".

Isn't that what he did? We were notified of the upcoming price increase, and to renew at the old rate for at LEAST a year (in fact, for as long as your billing info hasn't changed), we could 1. do nothing, we'd already get the time-limited discount or 2. give new billing info with a card with a further expiration date.

I don't see what is so confusing. Basically, you either agree with me or you don't. To have a discount based on credit cards, credit card renewals, etc. is not only crazy, it presents issues just like this.

The price should go up. EVERYONE should have to pay it. I pay the increase for my Sirius account, my Pandora account, my Microsoft Partner Acount, my ESET NOD32 antivirus account, my Backup Assist account and on and on. I see no reason why I should pay less when I use the exact EMR as the new users.

But, if we are going to get discounts, then just give us a discount. Go to the site and pay what you pay for a new year based on how many years you have owned AC. Why should you be penalized if you pay by PayPal, check, cash, money order or whatever.

No offense to Jon, but there is a reason no other company has ever done it this way. It is just a silly and problematic way to do it as he states clearly in his post.

I, too appreciate both Dr. Bertman's generous approach to pricing as well as his refreshing willingness to discuss the issue.

AC is priced at the far low end of EMR's. This is even more true as additional features, such as eRx, MU, and practice management are added. Unfortunately, even if the price is held very low, a dramatic increase is seen as being tough to swallow. So, for example, when Alexis sees a now doubled price of about $2000, her reaction is not the new user's "what a deal", it is more like Wendell's "ouch". This is not to criticize; I would react the same way. Certainly an unintended consequence of a real cost savings and an act of generosity on the part of the company.

So Dr. Bertman, if you want to reward some users, but be more sure they feel rewarded, I would suggest that you eliminate the current credit card policy. If you want to reward long-time users, how about the following: have a graduated fee schedule for maintenance. Keep the purchase price the same, but give a discount (say $100/year) for those who have had a maintenance contract for 3 years, and perhaps $200/year for 5 year users. Or more if you like.

Oh, and in honor of the program's creator, maybe waive the fee entirely for all users named Jonathan.

If you need to raise your price again, I would just say "as of Jan 1st, the price goes up". Period. If you wanted to be "fair" you could offer current users to prepay prior to Jan 1st the the current price giving them a few months break. The thoughtful consideration on your part was appreciated. I was one of those whose credit card expired right after the price increase so my benefit from the policy was minimal. I figured, oh well, I didn't win the lottery this week either. Maybe next week.

Of course, as a long time user, I like this approach, but there is merit there.

I would suspect that new and short time users require a lot more support that older users. Sure, you have to balance it out. New upgrades may require using services more. It may be not that difficult to determine a spread of use by years of service. If this is indeed the case and IFF Jon wants to reward longer users, then this would be an easy way to implement this.

But a concept of discount for longer use of service might be an equitable arrancement. As Jon (Bertman) said this will be discussed further in the ACUC.

I had a similiar issue that happened to me. My identity was stolen (there are so many who want to be me!), actually it was just my credit card and the credit card company caught it and sent me a new card, which caused the problem experienced by others above re: the pricing. Jon was great about how he explained the policy to me. The AC staff was supportive. I am so happy with AC and realize it's the best bang for the buck. It will never be referenced in Extormity.com.
In thinking further about the pricing, I charge the patients that started with me 22 years ago the same I charge people who are brand new patients today. Just a thought.

Jonathon Thomas Young (in case that jonathon discount works)

If Jon Bertman likes my proposal, I will expect to see posts by Jonathan Bert Adams, Jonathan Leslie Strouse, and Jonathan Wendell Wheeler.

We all go by Jon for short

I agree with Tom. A 99213 is the same for a patient of 20 years as it is for a new patient.

Discounts are for one time buys (usually) like a discount on comptuers because you bought five.

Maybe someone has mentioned this but, if not, I don't know how. Forget the CC stuff and do the "what is in effect a subcription service" and do it like almost EVERY other company does it.

Either when I am up for renewal or just starting, I am usually given three prices next to radio buttons:

_ $200 for one year
_ $150 for two years
_ $125 for three years

Thanks everyone,

I think we have raised some good questions and answers. I appreciated the fact that AC is very open and honest.

Hope all is better Alexis, we all just have admire a woman with a truck....or mules.

Am I missing something or is printing remotely worth $69.95 a year. I have never found myself needed to print something over the network.

Again, please don't take that critically. I am sure it is important for some.

Wrong thread, Bert?
I think you meant that to go in Dave's Logmein error thread. I will just roll with it and assume we are there....I pay the $ to Logmein because it is such great program and saves me so much time, that I want to support them.

Oh, sorry.

Oh, I agree, I do that all the time, but it seemed like the gist of the other thread were users not being able to print. I always thought that LogMeIn free should be just a bit more crippled and the pro version should be a bit better.

I agree it was confusing.
I had thought that as long as you kept a card on file for automatic payment you would keep your present rate.

I did not understand that it was designed to expire at some point in the future.

I appreciated the discount while available, probably going up soon. I do understand the need for increased rates over time to keep a good product.

Greg

I echo that. Apparently there is some fine print in the EULA that allows them to do that. We had a price guarentee of support at $500/year guaranteed for 2 years. Our card was also stolen and replaced. Considering the issue was not communicated to me before they went ahead and upped it one day after the time expired this truly smacks of unethical, or at least poor business practice and support of their customers. I am also trying to kick the issue upstairs as the minor dignitaries are not being helpful or understanding. Since word of mouth is likely their best form of advertising.....this might cost them more than it is worth.

For me, this has always been an issue. I think they should dump the whole credit card thing. Maybe a discount for paying early or seniority but even that I don't like.

I don't understand - I thought he got rid of the credit card on file last year when he did a one time you could buy 2 years of support for 1,000 and then it was to normal rates from then on. I prepayed for 2 years and next year understood that it would be 1,000 per provider.

That was my understanding as well

The two year price guarantee was an offer based on pre-paying the $1000 for two years by 12/1/2010. You had to proactively make the payment by that date. Did you do so? If so, you are all set. If not, then the increase is not related to the credit card issue, but rather your decision not to pay by that deadline.

Wendell and JBS,

Do you not remember JB showing us in Tahoe he still had every one's credit card info on file?

Leslie,
Tahoe? Those big Ford cars? Don't know what you mean.
Are you aware that your PM box is full and no one can send you messages anymore? I guess we have to resort to regular email.

I understand a lot more after I took the time reading the thread instead of glancing in between patients and emailing frantically. I apparently did not get the 2 years in advance thing. At the time I purchased AC exactly a year ago I misunderstood that this was for tech support alone. I did not realize that eprescribe was part of that and not available as a stand alone product.

I also have appreciated AC for response to questions and access to the people operating it. So my choice, now that I am a bit more calm and understand it, is simply whether to pay $995/year for eprescribe or not. I am not sure I can justify this economically for a small subspecialty practice since I may write only 2-3 scripts a day at most.

Meaningful use is pretty hard to reach for us that don't have a general medical practice. Time spent to satisfy the requirements takes away from seeing the patient. I generally spend an hour with a new patient as a specialist in dizziness. Is their height relevant unless it is very high or very low?

But that is another discussion for another day. I try to avoid the "I walked to school in the snow" response when discussing things like resident hours.

So are you saying you are no longer going to upgrade. If you are on v5.029, are you going to stay with that version forever. Are you not going to try v7. The $995 per year is for tech support and all updates and upgrades. ePrescribing just happens to come with it.

DrJJ -

I think you need to consider your option of tech support - although you may not use it much you are going to get bug fixes, ICD 9 and CPT upgrades (and this is important, particularly as we enter ICD10) and any upgrades as they appear. I do think even specialists can meet at least year 1 of MU with some work which would pay for 18 years of support.

I find it not that hard to do ht / wt - but if it really does not matter to you then at least put in stated height which calculates BMI.

Don't get discouraged - I do think that support is worth 1,000 per year even though I realize it is hard to make out the check at the time.

@JBS,

I never even knew there was a quota for the PMs. I cleared them out...they went back to 2007!!

200 for users
10,000 for mods

Apparently, Jon thinks mods do a lot of messaging.

Didn't I just say that in slightly different words?