My wife is a cash-only practice, although she'll put together a superbill if you want to try and hit your insurance. Last year she started contracting out to a firm that does nothing but pump up your patient notes into checking more superbill boxes - the end result being approximately 200% greater returns from the insurance companies. Keep in mind: my wife, in a former life, designed insurance plans for a multinational. In other words, a doctor who spent ten years in the insurance industry can get her patients three times as much money back if she hands her patient notes over to a 3rd party that exists solely to pickaxe more money out of insurance companies by knowing which boxes to check. Ladies and gentlemen, the ICD-10. Take a bow, Medicare.