SECOND AMENDMENT TO CREDIT AGREEMENT
                      ------------------------------------

         This SECOND AMENDMENT TO CREDIT AGREEMENT (this "Amendment") is entered
into as of September 24, 2007, by and among the lenders identified on the
signature pages hereof (such lenders, together with their respective successors
and permitted assigns, are referred to hereinafter each individually as a
"Lender" and collectively as the "Lenders"), WELLS FARGO FOOTHILL, INC., a
California corporation, as the administrative agent for the Lenders (in such
capacity, together with its successors and assigns in such capacity, "Agent"),
and ORION HEALTHCORP, INC., a Delaware Corporation ("Company"), and each of the
Company's Subsidiaries thereto (Company and each Subsidiary individually a
"Borrower" and collectively, jointly and severally, the "Borrowers"), with
respect to the following:

        A. The Borrowers, Agent and the Lenders have previously entered into
that certain Credit Agreement dated as of December 1, 2006 (as amended,
modified, renewed, extended, or replaced at any time or from time to time, the
"Credit Agreement").

        B. The Borrowers have requested that the Agent and the Lenders signatory
hereto amend the Fixed Charge Coverage Ratio under Section 6.16(b) of the Credit
Agreement beginning with the fiscal quarter period ending as of June 30, 2007
and to amend the Senior Leverage Ratio under Section 6.16(c) of the Credit
Agreement beginning with the month end of May, 2007. Agent and the Lenders have
agreed to amend the Credit Agreement on the terms and subject to the conditions
set forth below.

         NOW, THEREFORE, the parties hereto do hereby agree as follows:

          1. Definitions Incorporated. Initially capitalized terms used but not
defined in this Amendment have the respective meanings set forth in the Credit
Agreement.

          2. Fixed Charge.

          (a) Section 6.16(b) of the Credit Agreement is amended and restated in
     its entirety as follows:

          "(b) Fixed Charge Coverage Ratio. Have a Fixed Charge Coverage Ratio,
     measured as of quarter-end, less than the required amount set forth in the
     following table for the applicable period set forth opposite thereto:
<TABLE>
<CAPTION>
<S>             <C>                         <C>
------------------------------------------------------------------------------------------------------

                 Applicable Ratio                             Applicable Period
------------------------------------------------------------------------------------------------------
                    1.40:1.00                               For the fiscal quarter
                                                            ending March 31, 2007
------------------------------------------------------------------------------------------------------
                    0.70:1.00              For the two fiscal quarter period ending as of June 30,
                                                                     2007
------------------------------------------------------------------------------------------------------
                    0.70:1.00                  For the three fiscal quarter period ending as of
                                                              September 30, 2007
------------------------------------------------------------------------------------------------------
                    0.70:1.00                  For the four fiscal quarter period ending as of
                                                              December 31, 2007
------------------------------------------------------------------------------------------------------
                    0.70:1.00                     For the four fiscal quarter period ending
                                                                March 31, 2008
------------------------------------------------------------------------------------------------------
                    0.70:1.00                  For the four fiscal quarter period ending as of
</TABLE>

                                       1
<PAGE>
<TABLE>
<CAPTION>
<S>             <C>                         <C>

                                                                June 30, 2008
------------------------------------------------------------------------------------------------------
                    0.70:1.00                  For the four fiscal quarter period ending as of
                                                              September 30, 2008
------------------------------------------------------------------------------------------------------
                    1.00:1.00                  For the four fiscal quarter period ending as of
                                                              December 31, 2008
------------------------------------------------------------------------------------------------------
                    1.20:1.00               For the four fiscal quarter period ending as of March
                                           31, 2009 and for each four fiscal quarter period ending
                                                                 thereafter"
 -----------------------------------------------------------------------------------------------------
</TABLE>


               (b) Section 6.16(c) of the Credit Agreement is amended and
          restated in its entirety as follows:

               "(c) Senior Leverage Ratio. Have a Senior Leverage Ratio,
          measured on a month-end basis, more than the applicable ratio set
          forth in the following table for the applicable date set forth
          opposite thereto:
<TABLE>
<CAPTION>
<S>                 <C>    <C>    <C>    <C>
------------------------------------------------------------------------------------------------------
                     Applicable Ratio                             Applicable Date
------------------------------------------------------------------------------------------------------
                         2.50:1.00                               December 31, 2006
------------------------------------------------------------------------------------------------------
                         2.50:1.00                                January 31, 2007
------------------------------------------------------------------------------------------------------
                         2.50:1.00                               February 28, 2007
------------------------------------------------------------------------------------------------------
                         2.50:1.00                                 March 31, 2007
------------------------------------------------------------------------------------------------------
                         2.50:1.00                                 April 30, 2007
------------------------------------------------------------------------------------------------------
                         2.85:1.00                                  May 31, 2007
------------------------------------------------------------------------------------------------------
                         2.85:1.00                                  June 30, 2007
------------------------------------------------------------------------------------------------------
                         2.85:1.00                                  July 31, 2007
------------------------------------------------------------------------------------------------------
                         2.85:1.00                                 August 31, 2007
------------------------------------------------------------------------------------------------------
                         2.85:1.00                               September 30, 2007
------------------------------------------------------------------------------------------------------
                         2.85:1.00                                October 31, 2007
------------------------------------------------------------------------------------------------------
                         2.85:1.00                                November 30, 2007
------------------------------------------------------------------------------------------------------
                         2.85:1.00                                December 31, 2007
------------------------------------------------------------------------------------------------------
                         2.75:1.00                                 January 31, 2008
------------------------------------------------------------------------------------------------------
                         2.75:1.00                                February 29, 2008
------------------------------------------------------------------------------------------------------
                         2.75:1.00                                  March 31, 2008
------------------------------------------------------------------------------------------------------
                         2.50:1.00                                  April 30, 2008
------------------------------------------------------------------------------------------------------
                         2.50:1.00                                   May 31, 2008
------------------------------------------------------------------------------------------------------
                         2.50:1.00                                  June 30, 2008
------------------------------------------------------------------------------------------------------
                         2.25:1.00                     July 31, 2008 and for each month ending
                                                                      thereafter"
------------------------------------------------------------------------------------------------------
</TABLE>

     3. Conditions Precedent. The obligations of Agent and the Lenders hereunder
will be effective only upon satisfaction of each of the following conditions
precedent, each in a manner in form and substance acceptable to Agent:

     (a)  Receipt by Agent of a fully-executed original of this Amendment;

                                       2
<PAGE>

(b) After giving effect to Section 2 above, no Defaults or Events of Default
   have occurred and are continuing; and

(c) Agent shall have received such other documents, certificates, opinions, and
   information that Agent may require, each in form and substance satisfactory
   to Agent in its sole discretion.

4. Borrowers' Representations and Warranties. To induce Agent and the Lenders to
   enter into this Amendment, the Borrowers represent and warrant to Agent and
   the Lenders as of the date hereof as follows: (a) this Amendment has been
   duly executed and delivered by the Borrowers, constitutes a legal and valid
   binding obligation of the Borrowers, enforceable against Borrowers in
   accordance with its terms, and has been duly authorized by all necessary
   corporate action; (b) the representations and warranties contained in the
   Credit Agreement and the other Loan Documents are, both before and after
   giving effect to this Amendment, true and correct in all material respects,
   except (i) where any such representation or warranty is already subject to a
   materiality standard, in which case such representation or warranty is true
   and correct in all respects, and (ii) to the extent any such representation
   or warranty is expressly stated to have been made as of a specific date, in
   which case each such representation and warranty is true and correct as of
   such specific date; and (c) after giving effect to Section 2 above, no
   Default or Event of Default has occurred and is continuing.

5. Reaffirmation. Except as specifically modified by this Amendment, the Credit
   Agreement and the other Loan Documents remain in full force and effect in
   accordance with their respective terms and are hereby ratified, reaffirmed
   and confirmed by the Borrowers.

6. Events of Default. Any failure to comply with the terms and conditions of
   this Amendment will constitute an Event of Default under the Credit
   Agreement.

7. Binding Effect; Benefits of Amendment. This Amendment shall be binding upon,
   inure to the benefit of and be enforceable by the Borrowers, Agent, each
   Lender and their respective successors and permitted assigns. This Amendment
   is entered into for the sole protection and benefit of the Borrowers, Agent,
   and the Lenders and their successors and permitted assigns, and no other
   Person shall be a direct or indirect beneficiary of, or shall have any direct
   or indirect cause of action or claim in connection with, this Amendment.

8. Counterparts; Telefacsimile Execution. This Amendment may be executed in any
   number of counterparts and by different parties hereto in separate
   counterparts, each of which when so executed shall be deemed to be an
   original and all of which taken together shall constitute but one and the
   same agreement. Delivery of an executed counterpart of this Amendment by
   telefacsimile or other electronic method of transmission shall be equally
   effective as delivery of an original executed counterpart of this Amendment.
   Any party delivering an executed counterpart of this Amendment by
   telefacsimile or other electronic method of transmission also shall deliver
   an original executed counterpart of this Amendment but the failure to deliver
   an original executed counterpart shall not affect the validity,
   enforceability, and bind effect of this Amendment.

9. Governing Law. The validity of this Amendment and the construction,
   interpretation, and enforcement hereof, and the rights of the parties hereto
   with respect to all matters arising hereunder or related hereto shall be
   determined under, governed by, and construed in accordance with the laws of
   the State of New York. Section 12 of the Credit Agreement is incorporated
   herein by reference.

                                       3

<PAGE>

10. Entire Agreement. This Amendment, together with the other Loan Documents,
   reflects the entire understanding of the parties with respect to the
   transactions contemplated hereby and shall not be contradicted or qualified
   by any other agreement, oral or written, before the date hereof.

         THIS WRITTEN AGREEMENT REPRESENTS THE FINAL AGREEMENT BETWEEN THE
         PARTIES AND MAY NOT BE CONTRADICTED BY EVIDENCE OF PRIOR,
         CONTEMPORANEOUS, OR SUBSEQUENT ORAL AGREEMENTS OF THE PARTIES. THERE
         ARE NO UNWRITTEN ORAL AGREEMENTS BETWEEN THE PARTIES.

   As used in the preceding sentence, "written agreement" means all of the Loan
   Documents, collectively, including this Amendment.

11. Costs and Expenses. The Borrowers agree to pay to each of Agent and the
   Lenders on demand the reasonable out-of-pocket costs and expenses of such
   Person, and the reasonable fees and disbursements of counsel to such Person,
   in connection with the negotiation, preparation, execution, delivery, and
   administration of this Amendment, and any amendments, modifications, or
   waivers of the terms thereof. The Borrowers agree to pay to Agent and the
   Lenders, on demand, all costs and expenses of such Person, and the fees and
   disbursements of counsel to such Person, in connection with the enforcement
   or attempted enforcement of, and preservation of rights or interests under,
   this Amendment, including any losses, costs and expenses sustained by such
   Person as a result of any failure by any Borrower to perform or observe its
   obligations contained in this Amendment.

                  [Remainder of Page Intentionally Left Blank]


                                       4

<PAGE>

         IN WITNESS WHEREOF, the parties hereto have duly executed this
Amendment as of the date first written above.

                              ORION HEALTHCORP, INC.



                              By:      /s/ Terrence L. Bauer
                                       -----------------------------------------
                              Name:    Terrence L. Bauer
                                       -----------------------------------------
                              Title:   President & CEO
                                       -----------------------------------

                              INTEGRATED PHYSICIAN SOLUTIONS, INC.

                              By:      /s/ Terrence L. Bauer
                                       -----------------------------------------
                              Name:    Terrence L. Bauer
                                       -----------------------------------------
                              Title:   President & CEO
                                       -----------------------------------

                              MEDICAL BILLING SERVICES, INC.

                              By:      /s/ Terrence L. Bauer
                                       -----------------------------------------
                              Name:    Terrence L. Bauer
                                       -----------------------------------------
                              Title:   CEO
                                       -----------------------------------------

                              ON-LINE ALTERNATIVES, INC.

                              By:      /s/ Terrence L. Bauer
                                       -----------------------------------------
                              Name:    Terrence L. Bauer
                                       -----------------------------------------
                              Title:   CEO
                                       -----------------------------------------

                              ON LINE PAYROLL SERVICES, INC.

                              By:      /s/ Terrence L. Bauer
                                       -----------------------------------------
                              Name:    Terrence L. Bauer
                                       -----------------------------------------
                              Title:   CEO
                                       -----------------------------------------

                              RAND MEDICAL BILLING, INC.

                              By:      /s/ Terrence L. Bauer
                                       -----------------------------------------
                              Name:    Terrence L. Bauer
                                       -----------------------------------------
                              Title:   CEO
                                       -----------------------------------------
<PAGE>

                              WELLS FARGO FOOTHILL, INC.,
                              a California corporation, as Agent and as a Lender

                              By:      /s/ Peter Freyer
                                       -----------------------------------------
                              Name:    Peter Freyer
                                       -----------------------------------------
                              Title:   Vice President
                                       -----------------------------------------