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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
+$15.5KMonthly collections, from $112.5K to $128K
5.2%Denial rate, down from 15%
$100KCleared 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.

SpecialtyInternal Medicine
Providers4
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
Before15%
After5.2%

Clean claim rate

Higher is better
Before90%
After98%

A/R over 90 days

Lower is better
Before$205K
After$105K

Patient balances collected

Higher is better
Before72%
After90%

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.

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.

Your practice next

Find out what your internal medicine practice is leaving uncollected

The Revenue Health 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.

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.