Surgery is perhaps unlike any other business in that you don't know if, how much or when you're going to be paid for your services.

"Yeah, that does have some truth to it," says Melody Rhodes, the biller and business office manager for the Castle SurgiCenter in Aurora, Ill. "You don't know the exact dollar and cent, but you can sort of guestimate it. This means you'd better have somebody really good in your billing department."