We use a custom MSaccess report to generates pdf billing sheets from the AC DB. I then FTP these billing sheets over to our biller on a weekly basis. Works fine for us and they charge us 5.5% of their collections (no charge for money we collect on our end). If they bring in $300000, then their services cost us $16500 (probably would reach $20000 at that revenue level with mailing of statements to patients included), cheaper than hiring my own biller and easier than dealing with the many insurance companies. The biller did all our credentialing, etc for the 5.5%. We also are in a rural area with 25000 people in our entire county. We have used this billing company for three years.
