EHR comparison for cash-pay practices (2026)
For a solo cash-pay hormone, weight-loss or functional practice, the EHRs that cover the most of the job in one place are OptiMantra, Cerbo, Practice Better, Healthie and Akute. Charm and Elation are stronger on clinical and primary care tools. Jane is a scheduling-first system with no lab ordering listed. The tables below show what each vendor's own pages say, as of October 2026.
Last checked: October 14, 2026. Every cell comes from the vendor's own pricing, feature, legal or help pages, linked in the row. Where a vendor's public pages don't say, we write "not listed" rather than guess. We are not affiliated with any of these vendors, we take no referral fees, and we don't sell software.
How do these EHRs compare on BAA, telehealth, labs and e-prescribing?
All eight vendors say they support HIPAA compliance, and six publish or state a BAA on their own site. Lab ordering is where they differ most. OptiMantra, Cerbo, Charm and Akute list direct Quest and Labcorp interfaces. Practice Better works through Rupa Health, Fullscript and Evexia. Healthie sells Quest, Labcorp and BioReference labs inside client packages.
| EHR | BAA | Telehealth | Lab integrations | E-prescribing | Checked |
|---|---|---|---|---|---|
| OptiMantra | Yes. A BAA is part of the license, signed when a trial converts to a paid account. | Included on its single plan (pricing) | Labcorp, Quest, Access, Rupa, Boston Heart, Evexia and others; Fullscript for supplements (integrations) | Optional eRx license with EPCS, sold as an add-on (pricing) | 2026-10-14 |
| Cerbo | Yes. Cerbo publishes its BAA (the contracting company is CerboOM, LLC). | Telemedicine add-on, per provider (pricing) | Quest (bi-directional), Labcorp, Access Medical Lab, Rupa Health and many specialty labs (integrations) | eRx, eFax and EPCS included for prescribing providers (pricing) | 2026-10-14 |
| Practice Better | Yes. Practice Better says a BAA is included on all paid plans. | One-on-one telehealth on paid plans; not on the free Sprout plan (pricing) | Rupa Health, Fullscript and Evexia Diagnostics from the Starter plan (pricing, integrations) | ePrescribe (EPCS) add-on from the Starter plan, through DrFirst (pricing) | 2026-10-14 |
| Healthie | Yes. Healthie's BAA takes effect when the account is created. | One-to-one video on all plans; group telehealth on Plus and Group (pricing) | Fullscript included. Quest, Labcorp and BioReference orders can be added to client packages on the upper plans; linking your own lab account is Enterprise only. | DoseSpot add-on per clinician; EPCS add-on (pricing) | 2026-10-14 |
| Charm | Listed on the pricing page; Charm asks you to contact support for BAA details. | Add-on on the Free and Encounter plans; covered on the Provider Plan (pricing FAQ) | "Ready to use" interfaces for Labcorp, Quest and other labs (EHR page); lab integration on every plan | eRx and EPCS as add-ons below the Provider Plan (pricing) | 2026-10-14 |
| Jane | Yes, on request. Jane's terms of use say it will enter its standard BAA with HIPAA-covered subscribers. | One-to-one telehealth on every plan; group telehealth is an add-on (pricing) | No lab-ordering integration listed; Fullscript is listed for supplements (integrations) | Not listed on the pricing page | 2026-10-14 |
| Elation | Not stated on the public pages we checked. Ask sales. | Integrated telehealth (telehealth page) | Lab orders and results interfaces (DPC page); specific labs not named there | Included ePrescribing (DPC page) | 2026-10-14 |
| Akute | Not stated on the pricing page, which says "fully encrypted, HIPAA-compliant". Ask sales. | Included from Essentials (pricing) | Quest, Labcorp, BioReference, CPL and others; Fullscript (integrations) | Surescripts e-prescribing included from Essentials (pricing) | 2026-10-14 |
Rupa Health is now part of Fullscript, which acquired it on October 10, 2024. Fullscript says current Rupa workflows don't change for now. An EHR that lists either one should keep working with your lab orders, but ask about the timeline.
How do they compare on payments, reminders and integrations?
Most cash-pay practices need three things here: recurring billing for programs or memberships, automatic reminders, and a way to connect the EHR to the rest of their tools. OptiMantra, Cerbo, Practice Better, Healthie, Elation and Akute all list recurring billing. Only Practice Better lists Zapier. Charm, Healthie, Cerbo, Elation and Akute offer an API, and OptiMantra offers outbound webhooks.
| EHR | Payments, packages, memberships | Automated reminders | API or Zapier-style integrations | Plans |
|---|---|---|---|---|
| OptiMantra | Integrated payments (Stripe, Fiserv, Authorize.net, Stax); recurring memberships and prepaid packages (FAQ) | Automated text and email reminders on the base plan; two-way texting is an add-on (pricing) | Outbound, CRM-agnostic webhooks; HighLevel and Zoho integrations (integrations) | One plan, priced per practitioner, plus add-ons (pricing) |
| Cerbo | Merchant services through Propelr, Bluefin or Stripe, with automated subscriptions; membership management; Hint integration (pricing) | Email notice, email reminder and text reminder, with editable wording (pricing FAQ) | Public API documentation (linked from pricing) | Priced by provider type, full-time or part-time (pricing) |
| Practice Better | Stripe-powered payments; packages, programs, memberships and installment plans (payments). Deposits and recurring payments start on Professional (pricing). | Email session reminders on every plan; SMS reminders from Professional, with a monthly allowance on Plus and Team (pricing); forms sent before or after sessions (automations) | Zapier from the Professional plan; other apps through a Connector Hub add-on (pricing) | Sprout (free), Starter, Professional, Plus, Team (pricing) |
| Healthie | Stripe payment processing; client packages with one-time or recurring billing (packages) | Email and SMS appointment reminders on all plans (pricing); Intake Flows send forms automatically (forms) | API access, with additional fees (pricing) | Core, Essentials, Plus, Group, Enterprise (pricing) |
| Charm | Credit card processing through Bluefin; billing packages; an eCommerce add-on for selling products through the portal (pricing). Memberships not listed. | Email reminders on every plan; text and voice notifications have plan limits or an add-on (pricing) | API access, charged separately (pricing) | Free, Encounter Plan, Provider Plan (pricing) |
| Jane | Card processing on all plans; packages and memberships on Thrive only (pricing) | Unlimited email reminders on all plans; SMS reminders on Practice and Thrive, where available by region; scheduled return-visit reminders on Thrive (pricing) | Not listed. Jane lists 18 named integrations, such as Mailchimp and Fullscript (integrations) | Balance, Practice, Thrive (pricing) |
| Elation | Native membership billing with automatic recurring charges, ACH and card payments, and patient self-enrollment (DPC page) | Automated text or email reminders with confirm and cancel options (scheduling update) | Open API, a developer sandbox and 300+ partner integrations (DPC page) | Quote only (pricing) |
| Akute | Integrated payment processor and membership management; Hint billing add-on (pricing, patient engagement) | Appointment reminders and cohort automations (home page, pricing) | API access on the Developer plan; custom API integrations on request (integrations) | Essentials, Premium, Developer, priced by clinician and active patients (pricing) |
We list plan names, not prices. Prices change often, and several vendors run introductory offers. Open each pricing link for current numbers.
Which EHR fits which kind of practice?
This column is our read, not the vendors' claims. It is based on the features in the tables above and on what a solo owner with one VA usually has to run: an intake form, a lab fee, a consult, then a monthly program.
| EHR | Built for, per the vendor | Best fit, in our view |
|---|---|---|
| OptiMantra | With Cerbo: functional, integrative, DPC, concierge, IV and HRT practices (merger release) | Solo hormone or functional practice that orders a lot of labs and sells memberships, and wants one flat plan |
| Cerbo | Functional and integrative medicine, DPC, cash-based, IV and BHRT (who we serve) | Functional or DPC-style practice that wants deep configuration and specialty labs, and has time to set it up |
| Practice Better | Health and wellness practices (features) | Program-heavy practice (weight-loss or functional programs, courses, group sessions) that wants Zapier and an easy start |
| Healthie | Private practices, groups and digital health companies (pricing) | Telehealth practice that sells bundled packages with labs and may grow into a multi-provider or app-based service |
| Charm | Independent practices, including integrative medicine (integrative page) | A very new practice watching cost, or one that also bills insurance and needs a certified EHR |
| Jane | Clinics of any size, priced per practitioner (pricing) | Practice whose main need is booking, with labs and prescribing handled in other tools |
| Elation | Independent primary care and DPC (DPC page) | Physician-led membership or concierge practice that does broad primary care alongside hormone care |
| Akute | DPC, concierge, digital health, wellness and integrative clinics (home page) | Telehealth weight-loss or hormone practice that wants automation by patient cohort and direct lab interfaces |
For the reasoning behind these picks, read our guide to choosing an EHR for a cash-pay practice. For the three most common shortlist names side by side, see OptiMantra vs Practice Better vs Healthie.
What these tables don't tell you
A feature on a pricing page is not the same as a workflow that runs on its own. Every EHR here can send a reminder before a booked visit. Fewer will chase a patient who filled in the intake form but never paid the lab fee, or who stopped refilling after month three.
Check how each one handles the steps before the first booking. That is where most cash-pay practices lose patients. Our guide to collecting lab fees before the consult walks through those steps.
Also check which of your other tools touch patient data. An EHR with a BAA doesn't cover the form builder, texting app or email tool next to it. Our list of tools that sign a BAA covers those.
How we check
- We read each vendor's own pricing page, feature pages, legal pages and help center. We don't use review sites or affiliate blogs as sources for table cells.
- We record what is listed, with the plan name where the vendor gives one. "Not listed" means we didn't find it on public pages. It may still exist, so ask the vendor.
- We re-check the full table every quarter, and sooner when a vendor announces a change.
- Spot an error? Email us at hello@telesystemaic.com with the vendor page that shows it. Please don't include any patient information.
This is general information, not legal advice. Confirm BAA terms with each vendor.
Changelog
- 2026-10-14: First version. Eight EHRs checked against vendor pages.
Common questions
Which EHRs sign a BAA?
As of October 2026, OptiMantra, Cerbo, Practice Better (paid plans), Healthie and Jane (on request) state on their own sites that they provide a BAA. Charm lists a BAA on its pricing page and asks you to contact support for details. Elation and Akute don't state it on the public pages we checked, so ask their sales teams.
Which EHRs order labs directly from Quest and Labcorp?
OptiMantra, Cerbo, Charm and Akute list Quest and Labcorp interfaces. Healthie lets you add Quest, Labcorp or BioReference orders to client packages on its upper plans. Practice Better orders through Rupa Health, Fullscript and Evexia instead.
Did OptiMantra and Cerbo merge?
Yes. Cerbo and OptiMantra announced a merger on December 3, 2025, under one CEO. Both products are still sold under their own names, and Cerbo's BAA now names CerboOM, LLC as the business associate.
Which EHRs connect to Zapier?
Of the eight, only Practice Better lists Zapier, from its Professional plan. Healthie, Cerbo, Charm, Elation and Akute offer an API, and OptiMantra offers outbound webhooks. These usually need a developer or an integration tool to use.
How often is this table updated?
We re-check every cell against vendor pages each quarter. The date at the top of the page and in each table caption shows the last check.