I used to do my billing in-house, and after several years, I couldn’t take it anymore. I was paying my biller close to $45k a year, paying about $2k a year in support/updates, and my biller spent hours on the phone arguing with the insurance plans, trying to figure out why they denied this or that. Now, I hired a medical billing companywho charges me 6%. So if I collect $500K from insurance, that’s $30k, a $17k savings right there. And if things slow down and I collect less, I pay less, whereas with my biller, I paid her the same regardless. I am able to access my account online, and I do catch some errors, but I don’t think they make any more errors than my biller. Of course, nothing is better than having one’s spouse be the biller! I wonder what others are doing, and what their experience has been.