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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.
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.
Confirm coverage for every service
- Eligibility verified before every appointment, including which preventive benefit applies
- A patient balance workflow at checkout
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
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 betterClean claim rate
Higher is betterA/R over 90 days
Lower is betterPatient balances collected
Higher is betterMonthly collections
Higher is betterEvery 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.
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.