Clean Claim Rate
98%
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Denials Reduction:
8-10%
Our Metrics in Numbers
Clean Claim Rate
HIPAA-Compliant Billing
Lower Overhead Costs
Denials Reduction
Billing Support
5 Hidden Revenue Leaks in Internal Medicine Billing
Let’s find out the 5 hidden revenue leaks in internal medicine billing that you may often face;
Front-End Registration and Eligibility Errors
You miss patient demographics or fail to verify insurance coverage, including copays, deductibles, and coinsurance coverage —which can lead to denials. Either your patient is out of coverage, or the insurance doesn’t cover the billed service.
01
Uncaptured Charges and Missed E&M Coding (Conservative Coding)
Providers undercode evaluation and management charges by using inaccurate codes, missing prolonged service time, or failing to log bedside/in-office procedures (such as joint injections or EKGs), leading to revenue loss.
02
02
Communication Gaps on Clinical Documentation & Queries
Your practice delivers the service, submits the claim, but it gets denied. This may be because clinical notes don’t align with the documented service, or because supporting documents aren’t attached to the submitted claims, leading to payment delays.
03
Unworked and Expired Accounts Receivable (A/R > 90 Days)
Internal medicine practices often lose revenue because they forget to work on claims that sit untouched for 90-120 days—meaning they may be denied or written off, and you may not even notice yet.
04
Unmonitored Contractual Underpayments
Payers reimburse claims at rates below negotiated fee schedules, and the practice accepts payment without auditing Electronic Remittance Advice (ERA) variances.
05
05
Internal Medicine Billing Services that Scale Your Revenue Cycle
Your internal medicine practice deserves timely payments, not denials; eClaim Solution is committed to that. We develop revenue cycle management strategies that improve reimbursements on time and accurately. Here is what our experts cover for your practice;
Eligibility & Insurance Benefits Verification
Don’t ignore your patient’s benefits plan. We verify your patient’s insurance and benefits plan coverage before the visit, including copays, deductibles, and coinsurance, to prevent future denials due to coverage issues.
Medical Coding & Charge Entry
Internal medicine uses various codes, including CPT, ICD-10, and HCPCS, and offers a range of services that require different codes. For example, chronic care management requires CPT code 99490, and Transitional Care Management requires 99495, based on medical decision-making. One wrong code can skew charge captures, resulting in downpayments or upcoding errors. eClaim Solution eliminates this risk by ensuring accurate medical coding, so you avoid upcoding and overcoding denials.
Prior Authorization & Referral Approval
eClaim Solution always obtains a prior authorization number from health insurance companies for high-cost internal medicine services, so your practice never has to write off claims.
Claim Scrubbing & Submission
Our claims management team scrubs each claim before submission to identify missing information, errors, patient demographic issues, and mismatched codes, helping prevent claim rejections. We also ensure claims are submitted within state-specific billing timelines to avoid write-offs.
Denial Management & Appeals
Claim denials are the worst part of billing, but we handle them smoothly and efficiently. Our denial experts identify root causes, fix issues, and build a strong appeal by attaching supporting medical-necessity documents to help you recover the maximum lost revenue.
Payment Posting & Patient Billing
eClaim Solution ensures accurate payments are posted by reconciling payments with ERA/EOB statements, verifying them, and then billing the patient and insurance portal.
Accounts Receivable Management
Your claims shouldn’t sit for more than 90-120 days; eClaim AR experts ensure that. We monitor and track claims weekly and monthly, generate AR reports, and verify all old, partially paid, unpaid claims and write-offs to keep AR days under 30.
State-Wise Billing for Internal Medicine Practices
eClaim Solution serves internal medicine practices, solo practitioners, clinics, and independent facilities state-wise. So, no matter where you are, we help you everywhere and ensure you get paid on time and accurately.
Outsource Internal Medicine Billing Services & Save 40% of Costs
In-house internal medicine billing can cost you more, as it includes staff training expenses, specialist’s salaries, and software expenditures. Outsourcing internal medicine billing services reduces these overhead costs and provides specialized support.
Outsourcing billing also helps you with;
- Improvement in reimbursement rates.
- Reduced administrative burden.
- Access to specialized coders and RCM managers.
- Dedicated managers who check and balance your billing.
- AR specialists who help reduce AR days.
- Minimum denials and more revenue growth.
- AHIMA- and AAPC-certified coding.
- HIPAA-compliant and secure billing.
eClaim Solution, Your Trusted Internal Medicine Billing Partner
eClaim Solution stands out as a reliable, trusted internal medicine billing partner because of our professionalism, commitment, and on-time revenue results. Look at what internal medicine practices have achieved by outsourcing their billing;
24/7 Billing Support
No matter where your practice is located, our billing team is always here to help. We offer 24/7 online billing support, so clients can ask questions anytime.
98% Clean Claim Submission Rate
Using real-time eligibility and prior authorization tools, we catch missing information, coding errors, and other requirements before submission, helping achieve a 98% clean claim rate.
Free Medical Billing Audits
With us, you get free medical billing audit services that help your internal medicine practice, clinic, or facility center understand the causes of revenue leakage and how they can improve it for revenue growth.
<30 A/R Days
Our AR specialists work weekly and monthly on your old, partially paid, and write-off claims, ensuring no revenue is left behind — keeping AR days under 30.
5-15% Revenue Growth
With clean claim rates, accurate coding, and timely insurance coverage verification, our team helps internal medicine practices improve revenue by 5-15%.
Payer-Specific Billing
From Medicare and Medicaid to other commercial insurance plans, our experts stay up to date on payer policies, internal medicine billing rules, and coding requirements to keep billing smooth.
Documentation Requirements for Specialized Internal Medicine Services
Specialized services may require additional documentation to support medical necessity, code selection, and payer-specific billing requirements.
| Specialized service | Documentation requirements |
|---|---|
|
Chronic care management (CCM) |
Applicable eligibility, patient consent, comprehensive care plan, care coordination activities, and time records when required. |
|
Transitional care management (TCM) |
Discharge information, timely contact with the patient or caregiver, medication reconciliation, and the required follow-up visit within the applicable timeframe. |
|
Preventive care services |
Preventive history, risk assessments, screenings, immunization records, and counseling provided. |
|
Diagnostic testing |
Clinical indication, test orders, results, interpretation when applicable, and documentation supporting medical necessity. |
|
Minor procedures |
Procedure performed, clinical indication, consent when applicable, relevant findings, and details of the service. |
|
Medication management |
Current medications, reconciliation, prescriptions, dosage changes, treatment response, and relevant monitoring. |
|
Telehealth services |
Applicable telehealth documentation, patient and provider locations when required, modality used, consent when required, and details of the encounter. |
Get a Free Internal Medicine Billing Audit
Find hidden revenue leaks, compliance issues, and coding errors that cost your practice and silently drain revenue. Let our medical billing audit specialist identify hidden issues and help your practice fix them to grow revenue.
- Minimum Delays
- Secure Payments
- More Revenue
Frequently Asked Questions
Internal medicine billing is the process of submitting and managing insurance claims for services provided by internal medicine physicians. It includes assigning accurate CPT and ICD-10-CM codes, verifying insurance eligibility, submitting claims, posting payments, and managing denials. Accurate internal medicine billing helps healthcare providers receive timely reimbursements while maintaining compliance with payer requirements.
Internal medicine billing involves verifying patient insurance, reviewing clinical documentation, assigning accurate CPT and ICD-10-CM codes, and submitting claims to insurance companies. The billing team then tracks claim status, posts payments, manages denials, and follows up on unpaid claims to help internal medicine practices receive accurate and timely reimbursements.
Internal medicine practices use CPT codes based on the specific services provided. Some of them include;
- E/M Service: CPT codes range from 99202 to 99215
- Chronic Care Management: CPT codes 99490, 99487/99489
- Transitional Care Management: CPT codes 99495, 99496, 99483
- Preventive and Wellness Services: CPT codes G0438, G0439, 99397
- In-Office Diagnostic & Procedures: CPT codes 93000, 36415, 94010, 94640, 96372
You can reduce claim denials in your internal medicine practice by verifying patient eligibility, using accurate CPT and ICD-10-CM codes, maintaining complete clinical documentation, and checking prior authorization requirements. Submit clean claims on time, follow payer-specific billing guidelines, and regularly review denial trends to identify and correct recurring errors.
Yes, eClaim Solution’s RCM experts can handle your EHR/EMR software for billing internal medicine services, with hands-on experience with major and minor software, including AthenaHealth, OfficeAlly, eClinicalWorks, Tebra, and more.