I'm a solo practitioner with a PA and have been using in house billing for most of my practice of 30 years. I left the group I started 18 years ago, and used a billing service for 2 years during tthe transition. My Biller took a specialty position and I was given 2 weeks notice. Silver tree was part of a group of venders that our IPA had as recommended. I never thought I was big enough or complicated enough to support paying a billing service. In 3 weeks we were up and running with a new schedule and instruction. My bottom line has increased by 20%. The fee I pay is more than paid for and I have peace of mind. They are local and easy to know and work with, including great communication with any issues. I can highly recommend silver tree to anyone.