1. Why the monthly price is not the cost
Three things sit outside the monthly number and all of them land in year one. A clinic comparing two products on the headline figure alone is comparing the least decisive part of the bill.
| Line | Why it is missed | When it hits |
|---|---|---|
| Activation or onboarding | Quoted separately, or not at all | Month one |
| The end of the intro rate | The low number is often months 1–3 | Month four |
| Per-provider additions | Priced per prescriber, not per clinic | The month you hire |
| Add-ons that were assumed included | Scribe, insurance billing, website, app | Whenever you switch one on |
The fourth row is the one that embarrasses people in month six. Work out which of those you actually need on day one, and get a written quote that includes them, before comparing anything.
2. The cheapest honest route: $0 to start
If you are not prescribing yet, the entry cost can genuinely be nothing for a while. Our Start-up plan is $0 for your first three months as a founding offer limited to the first 100 clinics, then $99 a month, cancel any time. There is no activation fee on it and your whole team is included.
That condition matters and we are stating it rather than burying it: the $0 is a founding offer with a cap, and the pricing page carries a live counter that closes it once 100 clinics have taken it. After that the plan is $99 a month from the start. If you are reading this later and the counter has run out, the rest of the arithmetic below still holds — only the first three months change.
What the Start-up plan covers, and what it does not:
| Included | Not included |
|---|---|
| Booking and reminders | e-Prescribing, including controlled substances |
| Charts and e-consents | Lab ordering and results |
| Payments and memberships | Telehealth visits |
| The patient app | The AI scribe, unless added |
| Unlimited staff | — |
It also carries practical limits worth knowing before you build on it: 5 GB of files and one location. A single-site practice storing notes and consents will not notice. A practice uploading large images across two sites will.
3. The year-one total, month by month
Here is the arithmetic with nothing hidden, for a solo clinic on monthly billing.
| Route | Activation | Months 1–3 | Months 4–12 | Year one |
|---|---|---|---|---|
| Start-up, founding offer | $0 | $0 | 9 × $99 = $891 | $891 |
| Start-up, after the offer closes | $0 | 3 × $99 = $297 | 9 × $99 = $891 | $1,188 |
| Prescribing, monthly | $250 | 3 × $99 = $297 | 9 × $199 = $1,791 | $2,338 |
| Prescribing, annual | $250 | $1,990 for the year (2 months free) | — | $2,240 |
Two things fall straight out of that table. Paying annually on the Prescribing plan saves about $98 in year one, which is real but smaller than people expect, because the intro rate already does most of the discounting. And the step from Start-up to Prescribing is not $100 a month — it is roughly $1,450 across year one once the activation fee is counted, because moving onto Prescribing pays the $250.
Additional prescribers are $99 a month each, or $990 a year. We are deliberately not multiplying that through the intro period, because how the intro rate applies to additional prescribers is not published — ask for it in writing rather than assuming, with us or anyone else.
4. The add-ons, and which ones a new clinic actually needs
Most of what gets sold as essential on day one is not.
| Add-on | Published price | Needed on day one? |
|---|---|---|
| AI scribe | One seat included with Prescribing; extra seats $49/mo | Only if you have a second provider seeing patients |
| Insurance billing | $149/mo, 100 claims, then $1.25 each | Only if you bill insurance, which most cash-pay clinics do not |
| Website | $99/mo | No, if you already have one that works |
| White-label patient app | $750 once, then $79/mo | No. This is a growth decision, not a launch one |
The scribe allowance is 100 scribed hours per seat per month, then $0.50 an hour. On a normal new-clinic schedule that cap is not close to binding; a prescriber running six hour-long visits a day would pass it.
5. Where cheap turns expensive
A low price is only low if leaving is possible. The cheapest-looking products in this category are often the ones that are most expensive to exit, and that cost arrives exactly when you can least absorb it.
| The trap | What it costs later |
|---|---|
| An export fee, or no export at all | You pay to retrieve your own records, or rebuild them |
| An annual contract with no exit | You carry a product that no longer fits for up to a year |
| Per-seat pricing with a growing team | Every front-desk hire raises the software bill |
| A free tier that cannot prescribe | A migration in month eight, when you are busiest |
The last one is worth planning around rather than avoiding. Starting on a non-prescribing plan is sensible if you are not prescribing yet. What makes it painful is discovering the migration only when you need to write your first script. Ask before you start what moving to the prescribing tier involves, what it costs, and whether your data moves with you. Ours is the $250 activation and the data stays in place, because it is the same system.
On exports generally: we publish a free full data export at any time, and we would rather win the renewal than hold the records. What it costs to leave your EHR covers where the federal right to your health information applies and where it does not.
6. How to compare two quotes honestly
Put both vendors into the same five rows and the cheaper one usually changes.
| Row | What to write in it |
|---|---|
| Activation or onboarding | The one-time number, in writing |
| Months 1–3 | The intro rate, and what ends it |
| Months 4–12 | The standing rate at your real headcount |
| Add-ons you will actually switch on | Scribe, billing, app — priced, not assumed |
| Exit | Format, scope, timing and fee for your data |
Then do it again for year two, with one more provider than you have now. Year two at your expected size is the number that decides whether a product is actually affordable, and it is the one almost nobody asks for.
7. Frequently asked questions
What is the cheapest EMR for a new practice?
For a practice that is not prescribing yet, the entry cost can be nothing for a period. Aminova publishes Start-up at $0 for the first three months as a founding offer capped at the first 100 clinics, then $99 a month with no activation fee.
How much does an EMR cost per month?
For a small cash-pay practice, commonly $99 to $199 a month per prescribing provider, plus a one-time activation fee and any add-ons. The monthly figure alone rarely matches what leaves your account in year one.
Is there an affordable EHR for a solo provider?
Yes, and the thing to compare is the year-one total rather than the monthly rate: activation, the intro period, the standing rate from month four, and the add-ons you will genuinely switch on.
What does an EMR activation fee cover?
Opening the account, configuring it with you and importing your data from your current system. Aminova publishes $250 on the Prescribing plan and no activation fee on Start-up.
Does a cheap EMR cost more later?
It can, in two places: per-seat pricing that charges for every non-clinical hire, and exit terms that make retrieving your own records slow or expensive. Settle both before you sign.