There are practice managers who can provide a lot of help, but there are also groups that function like a co-op. In that type of group everything is provided or available through the group and you pay your share of the overhead. When I started at my current site I was free to hire my own MA, set up my rooms the way I want, accept the patients that I want, see as many as I want each day, ... The group negotiates with the insurance companies and takes care of all the paperwork. I have to sign the papers and pay my bills, and then I pay a core fee to cover all the shared expenses and that came to 19% this year. Its kind of like self-employment for dummies and it makes me appreciate what a solo doc has to go through. Overall the group arrangement is very profitable and I kept 61% of my collections this year.