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#67306
10/14/2015 5:05 PM
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OP
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I received an e-mail today stating that at the beginning of the year I will have to start paying an annual fee for maintenance of interfaces. One of the reasons I chose Amazing Charts was the fact that interfaces were a one time fee. One of the reasons they give is that interface issues are generate the second largest amount of support calls. If that is truly the case, then maybe Amazing Charts should chart a support incident fee for such help, and not charge those of us who have NEVER called for support of an interface. This has such a feel of bait and switch. I bought interfaces for a one-time fee, that was the contractual understanding. Hopefully some of that money will go to working on all the bugs and speed issues that still exist in the EMR. Here is the text of the e-mail I received. Of course, when I call client services, no one answers. Notice of Policy Update:
New Annual Interface Maintenance Fee
Interface Maintenance fee will fund ongoing development and support
Hello,
We are writing to notify you of an important policy change.
In order to continue providing you with the highest quality products and services, an annual Interface Maintenance Fee will be required for Amazing Charts EHR interfaces to most third-party products and services.
This new policy goes into effect January 1, 2016.
Why a new fee?
For many years, Amazing Charts was the only major EHR vendor that did not charge an annual maintenance fee for interfaces. This business model, however, was unsustainable over the long term.
HL7, X-Link, and other interfaces need to be updated and kept compliant with ever-changing technology and regulatory requirements. This means hiring development resources like software engineers and QA testers.
Additionally, issues with interfaces are the #2 reason for calls to Technical Support. This fee will allow us to help you when you need help most, so you can quickly get back to seeing patients.
How it works
The new fee applies to all interfaces, with the exception of Updox, Phreesia, and all of your State Immunization Registries, which will continue to be supported at no additional cost.
The annual maintenance fee will be calculated as follows:
Interfaces
First and second interfaces are $150 each
Third interface and each additional are $50
Medical Device Interfaces
$50 per device interface
The Interface Maintenance Fee will be billed annually on the anniversary date of your interface activation. For example, if your lab interface was activated on August 1, 2010, your Interface Maintenance Fee will be billed annually on August 1.
The Interface Maintenance Fee will be charged automatically to your credit card on file.
If you purchased an interface in the past and no longer use it, just let us know and we can turn it off. No one will be charged a fee for an interface they don't want or use.
Questions? Want to learn more?
We've created an online document to answer Frequently Asked Questions. You can also call Client Services at (866) 382-5932 or write to support@amazingcharts.com.
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In fact, the website even continues to state that there are no additional charges as long as I subscribe to Guardian Angel Support. Interface charges are for Amazing Charts' connection to the third-party product only. Many of these third-party products cost money themselves, and/or may charge more for their side of the interface to an EHR. Interface charges do not recur if you subscribe to Guardian Angel Support & Maintenance service (so you can get the updates and interface enhancements as they are released). Non-subscribers to our maintenance service will be charged annually for these interfaces. - See more at: http://amazingcharts.com/products/transparent-pricing/#sthash.ZE1U6Ed9.dpuf
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How do i check how many interfaces i have? i used to use trial version of interface three years ago so i don't want to be charged for those interfaces. Last month, I paid to eprescribe controlled substances and still I haven't heard anything from them.
Thuya
Family Practice
Dover, DE
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Looks like a major clarification will be in order from AC/Pri-Med about this does yearly support fee cover interfaces or not.
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Nickels and Dimes .... Keep coming ....
Roger
Working Hard for the children in the community.
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I've asked AC Support to resend email with clarification of yearly support fee and if interface maintenance fee is covered or not.
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and just to bitch some more if all interfaces after 2 only cost $50./yr each to maintain, then the initial first 2 interfaces fee has $200. of gravy for AC.
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The key is going to be if AC does charge for the interfaces, will they answer the phone and fix the issue right away?
Bert
Pediatrics
Brewer, Maine
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I can see their winning business model: first, they create a lousy software with bugs and then they charge to fix it.
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Frankly, I don't see how AC can charge folks who bought the interfaces under the agreement that there was only a one time fee. I agree with the initial post that it sounds like a contractual violation to me. Claim in the making anyone? AC continues to do things that further erode goodwill and user loyalty. Poor support, increased annual fee, now this bright idea. No wonder that users are jumping ship. Perhaps it is AC's nefarious plan to force everyone off the old AC and onto their new product. I do miss the days of "kind capitalism", and AC's core mission to help us, and be our partner in the difficult small practice world. Corporate mentality has taken over.....sad.  If revenue needs to be increased, at least do it fairly, with pay per incident support. Stop penalizing those of us who never use support. It's time to break away from the all included model. It does not work under the current regime.
Donna
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Please tell me--
Which software is more user-friendly and less buggy.
Which costs less and has a kinder, gentler business model.
I'm all ears -- I like AC ok, but it has its problems.
I just don't know what would not be out of frying pan into fire --
All the EHR's I have seen are problematic.
Sort of what is the least worst?
Tom Duncan
Family Practice
Astoria OR
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As far as a business model goes, I don't think it should be:
Let's be the least worst.
Bert
Pediatrics
Brewer, Maine
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As far as a business model goes, I don't think it should be:
Let's be the least worst. Must be the fatigue but why does the above sound like an intro to a "...Yo Momma's So Fat..." joke? I apologize if unintentionally offended anyone.
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Corollaries:
1.) What if the lab paid the interface fee? Is AC now going to bill me yearly?
2.) If so: In my practice, 95% patients go to BIG Lab, and 5% go to SMALL lab, and I'm not about to shell out two lab yearly subscriptions fees, so I'll need to contemplating cancelling my interface to SMALL lab who won't be happy either after they paid the interface fee. SMALL lab will now have the added expense of faxing all my labs, which at 5% won't hurt my MU stats. An since it is a pain to import faxes rather than the interface to AC, we will drop SMALL lab from the pre-printed choice of labs. While this may make business sense to AC, it creates conflicts for small practices (me) and the kindred small labs we hoped to support.
The ramifications are not good.
Mike
Family Practice
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SoCalFP. Exactly. I am going to do the same.
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I'm still waiting for someone to tell me --
If I want to jump ship and leave AC, where should I go?
Name one option that is better.
They are all bad, so far as I can tell.
Tom Duncan
Family Practice
Astoria OR
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Guess that's what AC is banking on
Bert
Pediatrics
Brewer, Maine
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Where's the old AC we grew to love? Designed by a physician for physicians? No, Pri-Med is focused on high-end practice management solutions that (at least according to posts because I dare not try it) are too buggy to be helpful? Additional add-ons that were supposed to have been included and now dictated "you will pay more if you want them and you need to have them because of Meaninful Use-HAHAHA." Meanwhile I swear that every website that I go to and journal I read has an ad for AC.....that can't be cheap. I'd like to keep using AC but every day something else isn't working--links go bad (just try getting into Epocrates these days from the tab). AC crashing more frequently and SLOW. I have a great main computer with 24 Gs of RAM and a SSD. I feel sorry for those trying to get by with less. Rant, rant, rant....no more raves about AC. Pri-Med....just fix up what you have!
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We need a Facebook page for AC users, independent from the company and this forum.
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So, if you check your interface list in administrator options, it includes Newcrop. Does this mean we are going to be charged another fee for Newcrop when prescribing is supposed to be part of our annual fee??? This whole scheme is very poorly thought out and explained by AC. But, I am afraid this is what we have come to expect. Upgrades with bugs, poorly chosen/instituted PM, poor corrrespondence, etc. Tom, I don't know what might be better, I haven't looked at the options for a while. There is always Practice Fusion, they have their own set of issues, but at least one does not pay to be aggravated. Athena is a very slick combo of charting and PM, but pricey. EMR summary
Donna
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Ask Brian Cotner about NextGen.  I have always heard it is next to the worse. No, I don't think NewCrop will be charged. It kinda comes with AC and is its own type of program.
Bert
Pediatrics
Brewer, Maine
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Hi all --
Just wanted to offer a few clarifications and answers to some of the questions above:
The eRX functionality is not considered an interface. It is an integral part of the EHR program. Continuous updates to the medications database and the cost of doing business with our partners Newcrop and SureScripts are covered under Guardian Angel Support and Maintenance.
This new Interface Maintenance Fee is not covered under Guardian Angel Support and Maintenance. It will be charged separately on the anniversary date of the interface activation.
The activation fee is still one-time and will not be charged again.
We apologize for not updating the website prior to the email and any confusion caused by this error. The website has been updated and states the current policy.
We will continue to evaluate all options for supporting the maintenance of interfaces.
I hope this helps answer some of the questions you may have. For additional information, please write to support@amazingcharts.com
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So, if you check your interface list in administrator options, it includes Newcrop. Does this mean we are going to be charged another fee for Newcrop when prescribing is supposed to be part of our annual fee??? This whole scheme is very poorly thought out and explained by AC. But, I am afraid this is what we have come to expect. Upgrades with bugs, poorly chosen/instituted PM, poor corrrespondence, etc. Tom, I don't know what might be better, I haven't looked at the options for a while. There is always Practice Fusion, they have their own set of issues, but at least one does not pay to be aggravated. Athena is a very slick combo of charting and PM, but pricey. EMR summaryDonna, We have an answer about about eRX, but the question remains about what happens when a user has paid a "one time activation fee" for an interface. Much like the discussion about the ownership of data, questions will remain until they are all adequately answered.
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I'm still waiting for someone to tell me --
If I want to jump ship and leave AC, where should I go?
Name one option that is better.
They are all bad, so far as I can tell. I have been dabbling with the drchrono free demo for a few months. Read the reviews, especially about customer service and response to customer feature requests. It's just so daunting to think of changing EMRs. Come on Amazing Charts, get your act together!
John
Internal Medicine
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I have been dabbling with the drchrono free demo for a few months. Read the reviews, especially about customer service and response to customer feature requests.
It's just so daunting to think of changing EMRs. Come on Amazing Charts, get your act together!
_________________________ John-- Dabbling in free demos is one thing; putting all your data in and hooking it up to a network of people who are barely computer-savvy and who become frustrated at the simplest glitch -- and who really just want to get their jobs done and go home to their kids is quite a different matter altogether. I'm not really arguing in support of AC -- only that these computer things become rather like a marriage. Sure, you can get divorced, but in the long run, are you really better off?
Tom Duncan
Family Practice
Astoria OR
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Tom could tell you better. But, I think when he wrote that he didn't mean help him find a better EMR. It was more about everyone wants to leave, but first tell me a better EMR than AC. Tell me if I am wrong Tom, and I will delete this.
Bert
Pediatrics
Brewer, Maine
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You don't need to delete it Bert.
I'm just generally frustrated with electronic records-- in the current iteration.
It was fine until "meaningful use" got going.
So AC and so far as I can tell -- EVERY other EMR -- suffers from the same constipation, just a little differently in each case, because they are trying to comply with government mandates that are simply impossible because they are internally contradictory.
Tom Duncan
Family Practice
Astoria OR
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You are ever so correct. I have said it here a hundred times. Meaningful use ruined the EMR. And every little thing that comes along which reimburses providers based on patient outcome will hinder medicine.
When you shingle a roof or paint a car, you are paid by the customer based on a preset agreement. If they don't like the service, they can choose to not use your service again. You aren't paid by some government's standard. Furthermore, you don't wait three weeks to be paid by shingle insurance.
I am starting to say this more now as we complain more and more about AC. We didn't have to do meaningful use. It would have been interesting if AC had refused to even acknowledge MU in the beginning. But, of course, that would have likely led to huge problems. But with no MU and no ACPM, AC would easily be sitting at the top of the EMH world. Notice I refuse to say EHR.
I hope when things become smooth again for all EMRs that the government comes out with ICD-20.
Bert
Pediatrics
Brewer, Maine
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Some reading this thread may think the extra interface fee per year is not that much (and I believe it is not), but the fee is another of many unfunded mandates.
If I were running a oil change place I could just add an Environmental Disposal Fee
A animal clinic, a HAZMAT disposal fee
A auto repair shop, a shop supplies fee
A cell phone company, a Regulatory Compliance fee
and the list goes on...
...KenP
Internist (retired 2020)
Florida
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I agree with all of the above, but...
AC has a business model that is somewhat difficult to support. They have been adding a number of staff to develop the program (as well as Inlight) but haven't raised fees for a while.
I do know that a significant amount of support is related to interfaces (it could be argued if they were better made there would be less support but...)
For what they add, paying $150 for the interfaces is not a significant amount of money.
At any rate, what is the alternative?
Wendell
Pediatrician in Chicago
The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
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The alternative is to fix the current support so that everyone is very happy, THEN add increase support costs. I hear that they are doing that. Just not good timing.
Bert
Pediatrics
Brewer, Maine
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INDY, is the NEWCROP interface turned on automatically when one registers for electronic prescribing? Will there be a continuing charge for this service. If a lab has paid for an interface, will they be billed or will we as the AC users be billed?
Doctor Mel
Family Practice, FAAFP
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As described here "The eRX functionality is not considered an interface" so there is no added charge for NewCrop.
Jon
GI
Baltimore
Reduce needless clicks!
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Isn't electronic communications with labs etc a MU requirement a vital part of an EHR?
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I think the board is a great place to commisserate and compalin about issues. Some things only change is they are brought directly to the attention to the top of the company. I wouldn't say this except that his email is posted directly in his signature. In the forum list under ICD-10, there is a post from the top guy. It has his email. Emails to him about your sentiments may mean more than posts here.
Bert
Pediatrics
Brewer, Maine
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Obviously nobody is happy about the increased costs, but what alternative do you have? Don't pay the fee and pay your staff to do the same work the interface was doing? Sure, but it would cost a lot more. Labs are a great example. Our clinic orders lots of labs every day. Getting rid of the interface would create more work for someone to scan in all the labs, then send them to the appropriate provider for sign off. I can tell you that if we paid someone hourly to do this, we would burn through the $150 in a couple days. On top of that, you wouldn't be able to run any reports on your scanned items. I am not supporting AC in raising costs, but I am resigned to it.
For those talking about jumping ship, using other EMR's that have great technical support. At what point to those companies start having support issues like AC when they get bigger?
I still don't see any better alternative EMR out there. AC has been suffering growing pains. I know that AC has been adding staff and they do care about the product. They just can't continue to add staff without more revenue. I'm in agreement with MU ruining everything.
When I speak to my colleagues about their EMR's, I still have yet to find someone that is 100% satisfied with theirs.
Marty
Physician Assistant
Fullerton, CA
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I'm not opposed to fees if we get appropriate service and value for it. Note to AC: you can charge more but at least promise faster/better service in relation to what you are charging for. As opposed to saying we're spending a lot of time on X, let's charge for it and continue same service as usual - that's what does not go over well.
Example: Labcorp interface was changed recently. Now if the patient demographics don't automatically match, we have to repeatedly match each panel result (bmp, cbc, etc.) I discussed with AC interface folks only to be told - that's the way it is. Well that's one thing when it's "free". If we're to pay yearly for the interface then AC had better fix the little issues that come up promptly.
I also asked them to streamline the manual patient matching for labs ( when not automatically matched). As it is you have to click type click type then click. Instead of automatically highlighting the last name field. It would be - type the last name, arrow up or down if needed to find name and hit enter. Was also told - "that's the way it is". Not good enough if they ask us to pay for interfaces.
Larry
Solo IM
Midwest
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I agree with beagle. I am not sure if there is a better EMR. But, my guess is there is better support. The problem that we read on the board all the time is just support's lack of getting back to users. I have suggested having someone always answer the phone, router the call to the right department and having a call back that day if, say, before 2 pm, and the next day if after. That would go a long way toward better support.
Bert
Pediatrics
Brewer, Maine
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I'm not opposed to fees if we get appropriate service and value for it. Note to AC: you can charge more but at least promise faster/better service in relation to what you are charging for. As opposed to saying we're spending a lot of time on X, let's charge for it and continue same service as usual - that's what does not go over well.. The problem is there are a boatload of interfaces and small amounts of people that use them. I suspect (and may have been told, I honestly don't remember (other board members can chime in)) that a large percentage of calls are for a small number of clients. This is commonly true 80% of use being 20% of the group (don't quote those numbers, I know they are not correct but the idea...) and additionally an inordinate number of calls are interface issues. While it can be argued that better interfaces would require less support, mine work well (but could be streamlined) and I suspect most do. Many people have interfaces that are not used much but take up resources. They are not charging for eRx (probably the MOST expensive interface, I know early on (under Bertman) there was a $40 monthly fee for this, it has been folded into the overall support fee.) They are also not charging for state interfaces for vaccines, which they are still working. I'm not defending, I do not relish paying extra money next year, but at least it makes some kind of sense. They gotta make money somewhere. Would you rather they raise the price on everyone for the support of a few?
Wendell
Pediatrician in Chicago
The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
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No argument here.
Just horrific timing.
Bert
Pediatrics
Brewer, Maine
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