How to Run an Entire Practice by Yourself: The 2026 Software Setup
How to run a whole practice alone in 2026: who answers the phone, who writes the note, who chases the claim - plus the real monthly cost for one.
You can run an entire practice by yourself when software covers the three jobs that normally need staff: answering the phone, writing the note, and chasing the claim. On Ona that is one practitioner seat at $130 a month, plus an AI receptionist add-on from $199 a month, quoted per practice, if you want calls answered.
Quick answer:
- The three staffed jobs are phones, documentation and revenue. Assign each to software before you assign it to a hire.
- A solo Ona setup starts at $130 a month for one practitioner seat, every feature included.
- Appeals, payer negotiations and note sign-off stay with you. Nothing sensible automates those.
The three jobs that decide whether you go solo
A one-person practice is four businesses on one calendar: the clinic, the front desk, the records department and the billing office. Most solo owners fail at the last three.
The load is measurable. In a time-and-motion study of 57 physicians published in Annals of Internal Medicine in 2016, Sinsky and colleagues found that during the office day physicians spent 27.0 percent of their time on direct clinical face time with patients and 49.2 percent on EHR and desk work. Roughly two hours of desk work per hour with a patient, before the phone rings.
So: who answers the phone, who writes the note, and who chases the claim.
Who answers the phone
This is the job solo owners underestimate. A call that hits voicemail during a visit is often a booking you never get.
An AI receptionist covers it. Ona's picks up 24/7, works out what the caller wants, books against real availability while honoring service duration and buffers, and writes the transcript and structured intake into the chart before the call disconnects. First-time callers land in the leads pipeline. Urgent symptoms, overdose and safety concerns bypass the agent entirely and ring a human, and anything you flag as human-only gets a warm transfer.
The honest alternative is a live answering service, and several are good. What you give up is the write-back: a person takes a message, they do not put structured intake on the chart.
Who writes the note
Documentation is the biggest time sink and the one job that needs your license, so automate the drafting and keep the signature.
Ona's ambient scribe records the visit in the room or on a telehealth call with per-visit patient consent, or takes uploaded audio afterward, then drafts a structured note against your template: SOAP, DAP, BIRP, a functional-medicine timeline, freeform, or one you build. Placeholder fields pull medications, allergies, vitals and history into the right slots. Every draft lands in review; nothing enters the record until you sign. Ona states it does not train models on your recordings.
Standalone AI scribes do this well too, and if your current system is otherwise fine, adding one is the cheapest fix on this page. The tradeoff is a second vendor, a second BAA, and a copy-paste step.
Who chases the claim
For cash-pay practices this is short: billing generates the invoice from the signed note, and payments run on Stripe at pass-through rates with Ona taking no cut.
If you bill insurance alone, you need three things before you can drop the biller. Real-time eligibility, so you know coverage, co-pay and deductible before the patient arrives. Claim generation that pre-fills a CMS-1500 from the note you already signed. And a visible pipeline from draft through submitted, acknowledged, accepted or denied, with a denial queue carrying the payer's reason. Ona's insurance module does all three, Medicare and Medicaid included.
What the Ona setup actually costs for one practitioner
Ona is an AI-native, all-in-one practice management platform, and it charges per seat with every feature on every plan. No higher tier to buy for claims. Published pricing, one practitioner, no staff:
- You, nothing else: $130 a month. One practitioner seat: scheduling, intake, consents, charting, the ambient scribe, telehealth, the portal, tasks, reports, leads, billing and insurance. Omnichannel messaging is free at two practitioners or fewer, so its $150 a month does not apply.
- You, prescribing: $175 a month. E-prescribing adds $45 per prescribing practitioner.
- You, prescribing controlled substances: $200 a month. EPCS adds $25 and requires e-prescribing.
- You, with the phone answered: $130 plus a quoted receptionist. The AI receptionist starts at $199 a month depending on the practice, with included minutes set per practice and $0.20 per minute beyond them. It is quoted per practice rather than list-priced, so the only exact figure is the one Ona gives you.
- Everything on: $200 plus that quote. Seat, e-prescribing and EPCS come to $200 a month; the receptionist quote sits on top.
- A part-time front desk later: +$45 a month for a staff seat.
No setup fees, no long-term contract. Migration from any EHR is free and typically lands within one business day, with full cutover usually one to three weeks for smaller practices. Practices with five or more practitioners, or multiple locations, get a tailored plan. Current figures live on the pricing page.
Ranked: solo setups compared
Ranked by how much of a one-person practice each setup covers before you add a second person or a second vendor. It is not a ranking of overall quality, and several of these will beat Ona on things a solo practice may care about more. Competitor figures come from each vendor's own pricing page, checked on 2026-08-19, and are the list prices those pages publish; SimplePractice and Freed were both showing promotional rates below list on that date. Jane figures are the US dollar prices published on its US pricing view.
| Rank | Setup | Who answers the phone | Documentation | Billing and claims | Published monthly cost basis |
|---|---|---|---|---|---|
| 1 | Ona | AI receptionist add-on: 24/7, books the live calendar, escalates urgent calls, writes intake to the chart | Ambient scribe and automated charting in the seat; you review and sign | In the seat: invoice from the signed note, real-time eligibility, CMS-1500 claims, denial queue | $130 seat; AI receptionist quoted per practice from $199 per month, with included minutes set per practice and $0.20 per minute beyond them; e-prescribing +$45; EPCS +$25 |
| 2 | SimplePractice + Note Taker | Not covered | Note Taker AI add-on, $35/mo | Varies by plan; ePrescribe $49/mo plus $89 setup | Starter $49, Essential $79, Plus $99 |
| 3 | Jane App + AI Scribe | Not covered | AI Scribe, USD $15/mo per opted-in practitioner for unlimited notes, or free for 5 notes a month | Insurance Billing add-on, USD $20/mo, plus USD $5 per additional full-time and USD $2.50 per additional part-time practitioner; not available on Balance | Balance USD $54, limited to 20 appointments a month; Practice USD $79; Thrive USD $99 |
| 4 | Practice Better + AI Charting | Not covered | AI Charting Assistant, $0.60/hour after 600 free minutes | Superbills on all paid plans; ePrescribe $49/mo plus $99 one-time onboarding per prescribing practitioner | Starter $35, Professional $69, Plus $99, Team $155 |
| 5 | Healthie + DoseSpot | Not covered | Charting from the Core plan | ClaimMD from $30/mo; DoseSpot $40 per clinician/mo | Core $19.99 (10 active clients), Essentials $49.99 (250), Plus $129.99 (unlimited) |
| 6 | Do-it-yourself stack | Live answering service, e.g. Smith.ai, which sells two separate lines. Live-agent receptionist plans: Starter $300/mo for 30 calls, Basic $810/mo for 90, Pro $2,100/mo for 300, with appointment booking a $1.50 per-call add-on. AI-only plans: free for 25 calls a month then $3.00 per call, Pro $150/mo, Enterprise $500/mo | Standalone scribe, e.g. Freed at $59 to $119/mo list, with the Starter tier showing a promotional $39 | Separate billing tool or an outside biller | Sum of the parts, plus the data you move by hand |
Where each fits: Healthie and Practice Better carry the lowest published entry prices in this table and are aimed at nutrition, coaching and wellness practices that sell packages, though Healthie's lower tiers cap active clients, so check the cap against your panel. Jane App is built for clinic disciplines such as physical therapy, chiropractic and massage. SimplePractice is aimed at behavioral health. If the phone is not your problem, pick on those strengths. Ona ranks first on one narrow axis: it is the only setup here where the phone, the note and the claim sit in the same product on the same record.
What still needs a human
Appeals and complex denials. A denial queue with payer reasons makes the work visible. Deciding what is worth appealing, and assembling the documentation, is still a person reading a policy.
Payer contracts and credentialing. Rates, network participation and credentialing timelines are conversations, not workflows. Budget real hours.
Clinical judgment and sign-off. Every AI draft lands in review and you sign it. Sensitive calls should ring a human, and Ona routes them that way by design.
The weekly admin block. Two hours in the calendar for the residue: unresolved claims, awkward messages, the patient who needs a call rather than a portal reply.
If your panel is insurance-heavy, a part-time biller may still pay for itself. One more thing matters when a single person is holding all of this: Ona states it is fully HIPAA compliant, with a BAA in place with every Ona workspace, so the calls, the notes and the claims sit inside one covered system instead of three. For what to automate first, see our companion guide on running a solo practice single-handed.
FAQ
How can I run my entire practice by myself?
Assign the three staffed jobs to software. Phones go to an AI receptionist that books on your live calendar and escalates urgent calls. Documentation goes to an ambient scribe that drafts the note for you to review and sign. Money goes to billing and claims that run off the signed note. You keep clinical judgment, sign-off, appeals and payer conversations.
What is the cheapest way to run a solo practice on Ona?
One practitioner seat at $130 per month. Every feature is on every plan, so that seat includes scheduling, intake, charting, the ambient scribe, telehealth, the patient portal, billing, eligibility and claims. Omnichannel messaging is free at two practitioners or fewer. E-prescribing adds $45 per prescribing practitioner, and EPCS adds $25 on top of it.
Do I need to hire someone to answer the phone?
Not necessarily. Ona's AI receptionist is an add-on from $199 per month depending on the practice, with included minutes set per practice and $0.20 per minute beyond them. It is quoted per practice rather than list-priced. It answers 24/7, books against real availability, routes urgent or sensitive calls to a human, and writes a transcript and structured intake into the chart. A live answering service is the alternative if you want a person on every call.
Can one person handle insurance claims alone?
Routine claims, yes. Ona runs real-time eligibility before the visit, generates a pre-filled CMS-1500 from the signed note, submits through an integrated clearinghouse, and tracks status through to payment with denials in their own queue. What stays manual is judgment: deciding what to appeal, assembling documentation, and negotiating payer contracts.
Next step
Bring your actual week to a demo: your call volume, your note format, your payers. Book a 15-minute walkthrough at ona.health/#demo, no obligation, then run the setup yourself on the 14-day free trial: full access, no credit card. If you stay, your data comes across free, usually within one business day.
Written by
Ona Health team