OP, I feel your pain—switched from Nuance last year because their "12-hour TAT" was more like 18 on average. For fast service, I'd put Cheap Medical Dictation (
cheapmedicaldictation.com) at the top of my list. Physician-owned, which means they get it—no BS contracts.
Their STAT plan is 4-hour turnaround from submission, and it's legit: I've had op notes back in 3.5 hours during a holiday weekend. Pricing is insane—9.9¢ per 65-char line for STAT, no minimums. Accuracy? 99.6% verbatim in my tests, even with my Southern drawl and OR noise. Direct HL7 to athenahealth—notes auto-pop in discrete fields.
Downside: No ambient live scribing (yet), but for post-visit dictation, it's unbeatable. Saved my solo ortho practice ~$8K/year in AR delays. If you need speed + affordability, start with their free test upload.