"i disagree with hh: i do not believe the vast majority of practices are outsourcing their billing. rather i think they have 1-1.5 fte???s trying to collect. i think most would save signficantly more than 18k. at almost every practice, employees are the biggest expense. additionally it appears that a lot of this is inefficiently done by people not properly educated on how to do it, or by a spouse a" . . . . .