# Internal Medicine Case Study

> See how WeBill Health defended revenue for an internal medicine practice through cleaner E/M coding, eligibility checks and faster A/R follow up.

Source: https://webillhealth.com/case-studies/internal-medicine/  
Publisher: WeBill Health  
Last updated: October 27, 2026

Case study · Internal Medicine

## $186K more in annualized collections for a 4 provider internal medicine practice

Denials were running at 15% and $205K sat in A/R past 90 days. Patients were paying only 72% of what they owed. Ninety days after WeBill Health took over the revenue cycle, every one of those numbers had moved.

4 providers$1.35M annual collections beforeResults measured at day 90

**+$15.5K**Monthly collections, from $112.5K to $128K

**5.2%**Denial rate, down from 15%

**$100K**Cleared from A/R over 90 days

**90%**Patient balances collected, up from 72%

The practice

## Care was delivered. Payment was not keeping up.

A four provider internal medicine practice caring for a large Medicare population with multiple chronic conditions. Complex visits were being coded simply, and preventive services were billed under the wrong rules.

| Specialty | Internal Medicine |
|---|---|
| Providers | 4 |
| Annual collections | $1.35M, about $112.5K a month |

What we found in the audit

### 15% of claims denied

Too many claims came back unpaid, with the same denials repeating month after month.

### $205K stuck past 90 days

Earned money was sitting in aging A/R with no one working it by payer or by filing deadline.

### 90% clean claim rate

Too many claims needed rework before a payer would even process them.

### 72% of patient balances collected

Copays and balances were left behind at checkout and never recovered.

What WeBill Health changed

## Seven fixes before the visit, in the coding and after submission

Every claim received human pre submission review by internal medicine coding experts, checked against our payer rule libraries for each carrier this practice bills.

Before the visit

### Confirm coverage for every service

* Eligibility verified before every appointment, including which preventive benefit applies
* A patient balance workflow at checkout

Coding

### Code the complexity you manage

* Chronic care coding matched to documented consent and monthly time
* Preventive visits billed under the correct Medicare or commercial benefit
* Human pre submission review of every claim against payer rules

After submission

### Recover what aged out

* Every denial traced to its root cause and neutralized there
* Aging A/R recovered in priority order by payer and by age

90 day results

## Before and after WeBill Health

### Denial rate

Lower is better

Before**15%

After**5.2%

### Clean claim rate

Higher is better

Before**90%

After**98%

### A/R over 90 days

Lower is better

Before**$205K

After**$105K

### Patient balances collected

Higher is better

Before**72%

After**90%

### Monthly collections

Higher is better

Before**$112.5K

After**$128K

Every bar starts at zero. Figures come from the practice’s own billing reports, comparing the baseline month with month three.

Where the $186K comes from

## An extra $15.5K collected every month

Monthly collections rose from $112.5K to $128K by day 90. Held for a full year, that is $186K the practice collects on care it was already delivering.

The gain came from specialty specific coding and fewer days in A/R. Fewer claims were denied, and balances that had aged past 90 days were finally collected.

Monthly collections before$112,500

Monthly collections at day 90$128,000

Increase per month$15,500

Annualized increase$186,000

Net return on the WeBill Health fee142%

Net return is the annualized increase in collections, minus the annual WeBill Health fee, divided by that fee. It is calculated before any savings from the practice’s previous billing arrangement.

The math

## Where the $15,500 a month came from

Estimated breakdown, built from internal medicine billing benchmarks and 2026 Medicare rates, tied to this practice’s measured before and after figures. Each line is a claim count multiplied by what those claims pay. A/R cleared from the old backlog is reported separately and is not part of this monthly gain.

| Change | Added a month |
|---|---|
| Denials stopped before they happenedAbout 879 claims a month at an average of $128 collected. Cutting the denial rate from 15% to 5.2% means 86 fewer denials a month. Before, about half of denials were never reworked, so 43 of those claims are now paid that were not. | $5,504 |
| Patient balances collectedPatients owe about $16,900 a month in copays, deductibles and coinsurance. Collection rose from 72% to 90%. | $3,042 |
| Chronic care management months billedPatients with two or more chronic conditions enrolled in 99490 with consent and 20 minutes documented, 63 a month at about $60 each. | $3,780 |
| Underpaid claims recovered69 claims a month paid below the contracted rate, short by an average of $46, now appealed and recovered. | $3,174 |
| Added collections a month at day 90 | $15,500 |

Prior authorization moved to WeBill Health as well. The AMA 2025 survey puts that work at 13 hours a week per physician, or about 52 hours a week for 4 providers. At the national median wage for medical administrative staff ($45,930 a year, BLS May 2025) plus benefits, that workload is worth about $85,298 a year in staff time.

Codes and conditions

## The claims behind these numbers

| Visit type | Codes and rules | Typical conditions (ICD 10) |
|---|---|---|
| Follow up for chronic conditions | 99213 or 99214 plus G2211 on Medicare | Essential hypertension I10; type 2 diabetes with hyperglycemia E11.65 |
| Annual wellness visit | G0438 once per lifetime, then G0439 every 12 months; problem visit with modifier 25 when separate | Hyperlipidemia E78.5 |
| Chronic care management | 99490 for the first 20 minutes a month, consent documented, not in a month with 99491 or 99487 | CKD stage 3 N18.30 with hypertension I10 |
| After a hospital stay | 99495 or 99496 transitional care, contact within two business days | Chronic diastolic heart failure I50.32 |

What it costs

## The 5% fee against the cost of doing this in house

This practice’s WeBill Health rate is 5% of collections. At $128,000 a month that is $76,800 a year. Here is what the same work costs a 4 provider practice that staffs it in house, before software and clearinghouse fees.

| Item | Per year |
|---|---|
| In house billing staff1.5 billers for 4 providers (MGMA: about one per two to three providers) at $73,160 each, the BLS median of $51,140 plus benefits | $109,740 |
| Prior authorization staff time13 hours a week per physician (AMA 2025), 52 hours a week, at the BLS median for medical administrative staff plus benefits | $85,298 |
| In house cost | $195,038 |
| WeBill Health fee, 5% of collections | $76,800 |
| Saved against in house staffing | $118,238 |
| Added collections a year | $186,000 |
| Better off each year with WeBill Health | $304,238 |

What other internal medicine practices can take from this

## Three internal medicine billing gaps worth checking this week

### Bill the Medicare wellness visit, not a physical

Medicare pays for the Annual Wellness Visit, G0438 for the first and G0439 after that, but does not cover a routine physical. Billing the wrong one leaves the visit unpaid or billed to the patient.

### Let E/M levels reflect chronic complexity

Managing several chronic conditions often supports a higher level of medical decision making. Notes that document the problems addressed and the risk involved support the level billed.

### Keep chronic care management claims audit ready

Chronic care management codes require documented patient consent and a minimum amount of clinical staff time each month.

[Request a Revenue Defense Audit](https://webillhealth.com/audit)[See all specialties](https://webillhealth.com/specialties/)

Your practice next

## Find out what your internal medicine practice is leaving uncollected

The Revenue Defense Audit reviews your denials, aging A/R and patient collections the same way we did here. You get a written report that ranks the fixes by dollars at stake. We reply within one business day.

[Request a Revenue Defense Audit](https://webillhealth.com/audit)[Check my Revenue Defense Score](https://webillhealth.com/revenue-defense-score/)

Questions

## About this case study

How fast did the results appear?

Every figure on this page was measured at day 90, comparing the practice's baseline month with its third month on WeBill Health.

Why is the practice not named?

We protect our clients' privacy. The figures come from the practice's own billing reports.

What drove the biggest change?

The denial rate. Cutting denials from 15% to 5.2% meant far more claims were paid the first time, which lifted monthly collections and stopped new balances from piling up in aging A/R.

Does WeBill Health work with other internal medicine practices?

Yes. Internal Medicine sits in our Office Visit and Consultation billing group. Every account is handled by coding experts who work internal medicine claims every day.

WeBill Health is a specialty focused revenue cycle management partner for independent practices. Request a Revenue Defense Audit at https://webillhealth.com/form/