We have a two-man internal medicine practice. We just have an answering machine at the office after hours that gives the patients our cell phone numbers to call if they need us. We take our own calls during the week, and one of us covers the weekends. We have found that we get fewer after-hour calls this way, which I think is because the patient is now calling our phone directly instead of getting a third-party (answering service), and some of them think twice about doing that. We also have many patients text us on our cells after hours. Total cost: nada. We were paying $80 a piece for answering service ($960 each)before we started doing this 4 years ago.