Kareo Alternatives: 4 Picks for 2026

Medical practices leaving Kareo, including groups now sitting inside a Tebra bundle, are not picking a twin. They are deciding whether the next system of record is another independent-practice EHR, a networked EHR-plus-RCM platform, or a claims engine that leaves the chart where it is. The four names that already appear beside Kareo on live healthcare pages do not all do the same job.

TL;DR: Drchrono is the tablet chart plus PM for independent clinics. Athenahealth is the networked EHR, PM, and RCM stack for groups that want the clearinghouse and rules inside the same tenant. AdvancedMD is the PM-first cloud suite the office manager can run at month-end. Waystar is not an EHR; it is the eligibility, claims, denials, and patient-pay engine you put under whatever chart you keep. None of the four publish a list price, so every commercial cell is quote only. Map the Kareo jobs you still have to cover, then get benchmarks from signed quotes.

How we evaluated

This page is a criteria pass. We scored each product against the jobs a Kareo practice actually runs: chart the visit, schedule the book, verify coverage, scrub and submit the claim, work denials, and collect the patient balance.

We listed four numbered entries because the title promises four, and we stopped there. Waystar stays on the list even though it is not an EHR, because that is how the live pages co-list it and because many Kareo exits are really RCM exits.

We printed no dollar figure next to Drchrono, Athenahealth, AdvancedMD, or Waystar. All four sit outside the vendor store we can cite. A guessed percent-of-collections or seat rate would be the number a partner repeats to a salesperson.

The clinic does this work inside a large bill. National health spending hit $5.3 trillion in 2024. The physician slice of that bill is the one a Kareo alternative has to post cleanly: according to CMS, national health spending grew 7.2% to $5.3 trillion in 2024, or $15,474 per person, with physician and clinical services at $1,109.7 billion and 8.1% growth that year.

Charting is already the default. according to CDC, 95.0% of office-based physicians used any EHR in 2024, with 83.6% on a certified system. A Kareo exit that only swaps the logo and leaves denials in the same pile is not a workflow change.

Burnout is the constraint on a heavier EHR. according to American Medical Association, 43.2% of physicians reported at least one burnout symptom in 2024, and family medicine sat at 46.4%. If the physicians will not live in Athenahealth's note or Drchrono's tablet, the office manager's favorite PM will still fail the vote.

None of the four vendors publish a list price here. Commercial terms stay quote only.

1. Drchrono

Drchrono is the pick when the physicians chart on a tablet, want specialty templates, and still need eRx plus a PM in one cloud tenant.

The buyer is an independent medical practice or specialty clinic, not a health-system core. Groups whose Kareo pain was the note, not the claim, land here. Groups whose Kareo pain was denials should not stop at the chart.

Ask the quote for rendering providers, in-house versus vendor billing, templates, eRx, telehealth, and the extract format. Quote only.

Drchrono will not replace Waystar as a dedicated RCM engine. If you need both a new chart and a heavier claims stack, that is two products, not a compromise.

2. Athenahealth

Athenahealth is the pick when the practice wants a networked EHR, PM, and RCM ruleset in one tenant, including the clearinghouse path Kareo was supposed to be.

The buyer is a medical group that will accept a more opinionated workflow in exchange for networked claim edits. Independent clinics that wanted a lightweight chart may find it heavier than Kareo. Physicians who already rejected extra clicks will need a template plan on day one.

Ask the quote for the collection of services you are actually buying (EHR, PM, RCM, patient portal), how unused modules are priced, data extract, and the dual-run month. Public list price is not published. Percent-of-collections talk belongs in the signed quote, not on this page.

Athenahealth is a full-stack alternative. It is not Waystar, and it is not a tablet-first specialty EHR. Put it on the shortlist if the Kareo exit is "we want the network," not if the exit is "we want a smaller note."

3. AdvancedMD

AdvancedMD is the pick when the office manager is the daily user, month-end reporting is the partner ritual, and the EHR can be the attached clinical file rather than the home screen.

The buyer is an independent medical group leaving Kareo's PM and wanting a cloud console billers already understand how to live in. Tablet-first specialists will feel like guests. A practice that only wants a new claims engine should look at Waystar and keep or separately replace the chart.

Ask the quote for PM versus EHR versus RCM, locations, clearinghouse, portal, conversion of appointments and balances, and training hours. Quote only.

AdvancedMD and Drchrono both hold a medical record. They split on who enjoys Tuesday. Do not shortlist both as if they were different jobs; pick one chart unless you have two buildings with two power users.

4. Waystar

Waystar is the pick when the Kareo pain was eligibility, claims, denials, and patient-pay, and the chart can stay.

It is an RCM and clearinghouse platform, not an EHR. Medical practices that already have a record and need a stronger claim path are the buyer. A clinic with no EHR cannot make Waystar the system of record.

Ask the quote for claim volume, eligibility modules, denial workflows, patient-pay, which PM or EHR it attaches to, and who owns historical claims. Quote only.

If the chart is also in scope, pair Waystar with Drchrono or AdvancedMD, or ask whether Athenahealth's RCM makes a second engine redundant. Do not treat Waystar as a Kareo-shaped EHR.

Kareo-exit criteria

Price policy: no printed figure for Drchrono, Athenahealth, AdvancedMD, or Waystar. Ask each vendor for seats, modules, volume, and migration.

That table is the partner memo. Three names can hold the chart. One name is the engine under the chart. Averaging their demo scores hides the split.

Administrative rails decide whether any of the four actually move cash. according to CAQH, medical plans reached 96% fully electronic eligibility verification in the 2024 Index while prior authorization sat at 35% electronic, claim submission sat at 98%, and attachments sat at 32%, with a $20 billion savings opportunity still on the table. A Kareo alternative that cannot park the 4% eligibility miss and the attachment gap will recreate the same workqueue.

Source: 2024 CAQH Index Report, medical plan adoption of fully electronic transactions.

No-shows and access still sit next to whatever PM you pick. according to MGMA, the single-specialty aggregate no-show rate rose to 6.81% in 2023, near the 7% mark from 2019, and 42% of group leaders in a January 2025 poll said their practices charge a no-show fee. An EHR swap that drops reminders is a volume cut. The patient scheduling software guide is the place to keep that job named.

Sources: CMS NHE Fact Sheet; CDC NCHS EHR FastStats; AMA specialty burnout article; MGMA Stat / DataDive no-show series.

Family-medicine burnout sat at 46.4% in 2024. If your Kareo panel is primary care, the note-click count on Athenahealth versus Drchrono is a staffing issue, not a preference.

Intake is the other leftover. Kareo never was a dedicated waiting-room product. If the clipboard is the failure, look at a front-door layer rather than asking Waystar or AdvancedMD to become one. The Phreesia-alternative intake guide is the workflow page for that job, and it is a separate buy from this four-name EHR-and-RCM shortlist.

Pros and cons

Drchrono

Pros: tablet-native chart, specialty templates, eRx, and a path to keep PM and billing in one tenant for independent clinics.

Cons: not a dedicated RCM engine, intake is not the product, quote only including the extract.

Athenahealth

Pros: networked EHR plus PM plus RCM in one tenant, which is the "we want the edits and the chart together" Kareo exit.

Cons: heavier workflow than a lightweight independent PM, physicians may push back on clicks, commercial terms including any collections share are quote only.

AdvancedMD

Pros: PM-first design the office manager can run, month-end reporting partners already know how to read, EHR attached.

Cons: weaker tablet story, not a standalone claims engine at Waystar's depth, list price not published.

Waystar

Pros: eligibility, claims, denials, and patient-pay as the primary job, without forcing a new chart.

Cons: not an EHR, you still need a system of record, quote hinges on volume and modules you cannot read off a webpage.

Switching cost off a Tebra/Kareo stack

The cost is data, retraining, and a quiet month. The Tebra wrap around Kareo can make ownership of the extract unclear, so name the file you need in the statement of work: notes, problems, meds, allergies, documents, appointments, balances, eligibility logs, and claim history.

If Drchrono, Athenahealth, or AdvancedMD is the destination, you are converting the chart and the PM. Dual-run the appointment book for 30 days. Shadow claims until the first ERA posts clean. Freeze extra customizations until month-end. Rebuild templates so physicians are not staring at a blank note.

If Waystar is the destination, the chart stays. You are converting eligibility connections, claim files, denial workqueues, and patient-pay posting. Dual-run a sample of payers until the 835 posts to the same balance the old stack would have posted. Retraining is billers, not the full physician panel.

Retraining for a full-stack swap is a slow week. Billers need denial reason codes mapped. Front desk needs the copay script. Physicians need the last note structure on day one if the EHR changed.

Intake and scheduling leftovers will spike. US Tech Automations can chase incomplete packets and run eligibility exceptions so the front desk is not re-keying portals during the dual-run. Keep those as named jobs, not as demo checkboxes.

Do not print a price comparison. Compare extracts, dual-run calendars, and module lists. For how leftover automation is sold, use the healthcare workflow automation pricing guide and the pricing page together, and see how the steps connect on the US Tech Automations homepage.

After the new PM is live, US Tech Automations can also assemble the next-visit packet so Drchrono or AdvancedMD users walk into a complete chart. That is a workflow on top of the four-name shortlist, which is the part this page will not pretend the EHR demo included.

Verdict for medical practices leaving Kareo

Pick Drchrono if the physicians will live in a tablet chart and you can staff or automate RCM around it.

Pick Athenahealth if you want the networked EHR, PM, and RCM rules in one tenant and the physicians will accept that workflow.

Pick AdvancedMD if the office manager runs the building and month-end is the hill.

Pick Waystar if the chart can stay and the pain is eligibility, claims, denials, and patient-pay.

Pick a pair if two holes are real: Waystar plus Drchrono, or Waystar plus AdvancedMD. Athenahealth plus Waystar is often redundant; make the quote prove otherwise.

Get benchmarks from quotes that list seats, modules, volume, and extract, then assign intake, scheduling, and eligibility exceptions as named jobs. US Tech Automations does that leftover layer; it does not pick the logo.

FAQs

Is Waystar a Kareo-shaped EHR?

No. Waystar is an RCM and clearinghouse platform, so you still need a medical record such as Drchrono, Athenahealth, or AdvancedMD.

Can we shortlist Drchrono and AdvancedMD as two different jobs?

No. Both hold a medical chart plus PM. They split on who the daily user is, so pick one chart unless you have two buildings with two power users.

Does Athenahealth publish a percent-of-collections rate we can print here?

No. Athenahealth is quote only on this page, so any collections share, seat, or module fee has to come from a signed quote.

How long should a Kareo-to-EHR dual-run last?

Plan 30 days of parallel appointment books, a claims shadow until the first ERA posts clean, and a freeze on extra customizations until the first close.

What should the extract include?

Notes, problems, meds, allergies, documents, appointments, balances, eligibility logs, and claim history, in a named format, with a named owner if Tebra and Kareo split the file.

Should we move intake in the same weekend as the EHR?

No. Keep the current packet path through the first clean week, or add a dedicated intake layer as a second project.

Who works eligibility exceptions after go-live?

The new PM or RCM should send the 270/271. Portal failures still need a named owner inside the practice or an agent layer.

Key Takeaways

• Four Kareo alternatives split three charts and one RCM engine; Waystar is not an EHR.

• Drchrono is tablet-first; AdvancedMD is PM-first; Athenahealth is the networked stack.

• 95.0% of office physicians already use an EHR, so the buy is claim path and daily user, not adoption.

• Every vendor on this page is quote only; get benchmarks from seats, modules, volume, and extract.

• Dual-run the book for 30 days on an EHR swap, and dual-run payers on an RCM-only swap.

• Keep intake, scheduling, and eligibility exceptions as named jobs on top of whichever logo you pick.