We brought billing in-house years ago due to problems with an outside biller. We started using Kareo which was not integrated to AC in any way. We changed to Caretracker (Harris Product) and it is interfaced with AC. I like having the person in the office to do the billing because if there are issues she is available to talk to the pt and myself and get things resolved locally. A name with a face that the patients can relate to not just a voice on a phone. Patients seem to appreciate this personal interaction. If want you can PM me and I'll have my biller talk to you or your staff. She has her complaints and problems but does tell me that the Caretracker program is much better that the separate AC/Kareo combo. Caretracker recently added an advanced scrubber (extra charge) but she feels it has helped. I spend about $800 per month for monthly billing including invoices generated by Caretracker. I do feel we send out too many bills and am trying to figure out how to decrease this number to decrease my monthly costs.