First know medical billing, then do NOT wait to get your software, shop around, demo and demo and demo, think about the FUTURE of your business, not shaving costs or you will regret it in the long run when you find that you need something more powerful and more up-to-date. Data conversions can be extremely expensive, unreliable and in the end cost you more than if you had spent the money from the get go. I also tell new billing companies to get familiar with as MANY PM systems as they can so that they are not turning down clients because they have their own systems in place. I've seen many billing companies lose out on clients because the client does not want to switch or move to another software to which the billing company is using. Today's billing company MUST be diversified. Personally I don't like any of the "free" software out there because in the long run it costs more when your business is ready to grow. You get what you pay for and not doing it the right way the first time is going to cost you both time and money. I know because I'm one of the many who discovered that later rather than sooner.