If your office has one or two billers who are extremely rheumatology billing services efficient and have been with you for a while, this may not be necessary. In contrast, if your practice sees high turnover rates for in-house specialists and has never had good collection rates, it may be time to search for help. If your office is a good candidate for Electronic Health Record (EHR) software systems, in-house management of bills may be a significant factor in deciding not to outsource. EHR systems can be expensive.