Insurance companies may reject claims because of inadequate documentation. Dictated notes or an electronic medical record provide an accurate and complete documentation of services. In a paper-based medical record system, significant amounts of professional fees are lost because the insurance companies reject claims without copies of the note. It is onerous to provide copies of the daily progress notes and bedside procedure notes to the billing service. Retrospective review of billing records for a 12-month period was performed. One partner took daily digital photos of all progress notes and made these available to be submitted with the claim. The other partner did not use this technique. Both partners dictated procedure notes which were available to the billing service for submission. The Wilcoxon's rank-sum test compared the reimbursement rates which were stratified for dictated procedures vs daily notes and insurance type between the two partners. More than 5000 billing submissions were analyzed. The reimbursement rate for procedures was similar for each surgeon (mean 18-19%). The reimbursement rate for daily progress notes was significantly higher for the surgeon using digital photography (mean 38% vs 29%, P < .05 by Wilcoxon's rank-sum test). Digital photography provides an easy means of documenting services. This provides proof of service to insurance companies and improves reimbursement. The same result could be provided by an electronic medical record, or by onsite billing personnel copying the medical record.