It has been proven that the average medical practice delivers close to a fifth of its services for free. Taking into consideration that in 83% of the cases the billing service software is done in-house, you can say that this system fails to provide the minimal payment performance. By doing a simple search in the Yellow Pages, you will discover that there are almost 4,000 companies that offer billing service software nationally. Also, there are over 100 similar services offered in New Jersey alone. Normally, the large number of companies that offer billing service software should be enough to guarantee the quality of the outsourced medical billing. However, one question lingers: could it be possible for the outsourced billing service software to improve or send payments while reducing costs? The two most important arguments there are in favor of the outsourced billing service software are the extra time and the cost gains. On one hand, the extra time is very useful, as the practice owner can use it for family, patient care, or practice development. Cost gains, on the other hand, are absolutely invaluable: they are measured in terms of salaries and benefits of staff. As expected, there are some opponents of outsourced billing service software as well. There are some doctors that might disagree with the first argument, given the fact that they already are pleased with their schedules. In addition, most of these opponents state that their arguments rely on the fact that up coding and bad follow up on denied claims can only point to the advantages brought by the billing service software when functioning in-house. All in all, the only solution is that practice owners establish objectives for their performances and use them when questioning about the use of outsourced medical billing service software.