Stats for this case study
60%
25%
2500
260K
Kris Epps-Martinez, Co-Owner
InVita Health and Wellness
Challenge
Within two years, InVita had grown from a back-of-a-napkin business plan with one service to a multi-service practice providing care to hundreds of patients. As patients began requesting insurance-billable treatments, founders Kris Epps-Martinez and Angelina Giles realized it would add a lot of complexity to manage their practice. They needed technology that could help them manage operations efficiently while expanding services and preparing to bill insurance.
Solution
After seeing a demonstration of Tebra, InVita’s founders quickly recognized the potential of an all-in-one platform. They adopted Tebra EHR+ to manage and simplify documentation, charting, patient communications and telehealth workflows in one system designed specifically for independent practices. As the practice expanded its services, they also added a professional biller and tapped Tebra Billing functionality to begin submitting insurance claims for primary care services.
Results
Within their first year using Tebra, InVita Health & Wellness grew 60% increasing from 900 to 1,500 unique patients. Additionally, Telehealth capabilities have enabled the practice to conduct 25% of their visits remotely, expanding access for patients across their region of Nebraska. With this kind of growth, and by streamlining process and workflows with Tebra, new practices like InVita could unlock an estimated $65k in annual operational capacity—freeing up provider time equivalent to 2,500 additional patient visits per year— and access more than $260k in insurance reimbursement.
Overview
After more than two decades in healthcare, Family Nurse Practitioner Kris Epps-Martinez and Angelina Giles, both a Family Nurse Practitioner and a Doctor of Nursing Practice, set out to close gaps in accessible care. In 2023 they launched InVita Health & Wellness to offer more affordable treatment including medical weight loss, bio-identical hormone replacement therapy, IV therapy, medical aesthetics and primary care.
Taking the start-up leap
For Epps-Martinez and Giles, launching an independent practice wasn’t just a career move — it was a mission.
From their deep healthcare experiences, they had seen firsthand how difficult it could be for patients to access affordable, responsive care. Too often, patients fell through the cracks of large healthcare systems that struggled to deliver personalized treatment.
That experience led to a conversation that would eventually turn into a business plan—one written on a cocktail napkin.
“We decided we were done working for others and took the leap!” says Epps-Martinez.
The two founders launched InVita Health & Wellness in Nebraska, one of the states where Nurse Practitioners can practice independently. Their first offering focused on infusion services designed to help patients suffering from chronic migraines recover faster and more affordably.
Demand quickly expanded beyond that initial service. Patients began asking for weight loss treatments, hormone replacement therapy, lab services, and eventually primary care.
“Since we launched, we’ve grown by building services our patients specifically asked for,” explains Epps-Martinez
In particular, perimenopausal women, a group chronically underserved in the healthcare industry, increasingly seek out InVita’s help.
Angelina Giles explains: “Today, too many women are not finding workable solutions after seeing multiple specialists, exhausting multiple avenues and battling huge lifestyle misconceptions.”
“Our philosophy is to address gaps in women’s healthcare through holistic, data-driven approaches that look at mental and physical well being and partner with them to reframe how they approach their care. We measure patient progress through laboratory studies and ‘non-scale’ victories, emphasizing the importance of listening to patients and reframing healthcare approaches.”
Finding the right EHR
As the practice expanded in response to their data-driven patient approach, the founders knew they needed technology to support their operations. Having worked in large healthcare systems, they understood the importance of an electronic health record system for charting and documentation—but they also knew how frustrating those systems could be.
“Our prior EHR, Elation, was okay, but the customer support disappeared once we signed the contract,” says Epps-Martinez.
“When I learned about Tebra from my neighbor, we were 100% cash pay for our patients. Since we launched, literally from my couch, we’ve grown by building services requested specifically by our patients. About that time, we were starting to get a lot more requests to offer primary care and insurance billing.
Around that time, a neighbor who had recently joined Tebra offered to give her a product demonstration. What started as a friendly practice pitch quickly turned into an eye-opening moment for the founders.
“We got the Tebra demo and—oh man—we saw all kinds of potential at a price that made sense for our small practice,” she recalls. “Tebra had the right scope, the right price, and the right access.”
EHR+ Built for Private Practice
InVita implemented Tebra’s EHR+ platform in early 2025, using it first for clinical documentation, patient communications, and telehealth.
Epps-Martinez even migrated their initial patient records herself.
“I feel like Tebra is idiot-proof,” she laughs. “I save lives, not computers.”
The platform quickly became a core part of how the practice operates. Built-in HIPAA certified telehealth enabled them to conduct roughly 25% of patient visits remotely, expanding access for patients who might otherwise struggle to travel for appointments.
Other features simplified day-to-day workflows. Built-in consent forms, patient messaging tools, and mass email capabilities allowed the founders to keep patients informed as they added new services.
One feature in particular became a favorite.
“For patients who come in regularly for things like weight loss treatments or lab work, the ‘Same as Last Time’ button saves us a lot of time,” says Epps-Martinez. “We don’t have to re-enter all the same information again.”
And for InVita’s founders, Tebra also provides them with both time and data to help them check their own practice health.
“We’re too busy NOT to meet,” says Giles. “We’ve doubled our staff in one year, so we’re good —and getting better— at carving out administrative time weekly to review our process, policies and practice operations.”
Growing with Tebra
As the practice continued to grow, the founders began preparing for another major milestone: accepting insurance.
For its first phase of growth, InVita operated entirely as a cash-pay practice. But as more patients requested primary care services, the founders realized insurance billing would allow them to serve a broader patient population.
In late 2025, Invita completed credentialing and brought on a professional healthcare biller who began using Tebra’s billing workflows to manage claims and payments.
“The process sync between Tebra and our biller has been really good,” says Epps-Martinez. “For such a complex area like billing, Tebra’s technology shortcuts are clutch.”
While insurance billing is still new for the practice, the founders expect it to play a major role in their next phase of growth.
“We’re only a few months into it,” she explains, “but in the next year insurance billing through Tebra should power our trajectory.”
Lessons in impact
For InVita’s founders, the most important lesson they share with other providers considering independent practice is simple: listen to patients and learn from your data.
“Let your patients lead your practice. Pay attention to what they’re asking for and build services around that need,” says Epps-Martinez.
“As healthcare providers, our duty is to be clinically knowledgeable and beneficial to the person in front of us,” adds Giles. “We compare against baseline data so that we are investing together with each patient on decision-making to optimize their well being. That can range from lab results like LDL cholesterol levels to ‘non-scale’ personal victories like being able to get on the floor and play with their grandchildren.”
With the right tools supporting their operations, the founders can focus on exactly that mission.
“Tebra gives us more time to find answers for our patients,” says Epps-Martinez. “Without it, we couldn’t provide the level of access and solutions that we do.”
Estimated financial impact with Tebra
Calculation assumptions for practices like InVita’s in Nebraska:
- 2 Family Nurse Practitioners
- Blended billing rate for FNP in Nebraska: $75/hr
- Average daily visits per 2 providers: 24
- Avg. visit length: 20 minutes
- 50 weeks/250 days per year
- Average insurance reimbursement: $130 per visit
| Impact Category | Operational Area | Calculation | Annual Value |
| Operational Efficiency | Clinical documentation | 5 min × 24 visits/day × 250 days ÷ 60 × $75 | $37,500 |
| Repeat treatment documentation | 3 min × 10 visits/day × 250 days ÷ 60 × $75 | $9,375 | |
| Telehealth workflow | 10 min × 6 visits/day × 250 days ÷ 60 × $75 | $18,750 | |
| Total Efficiency Value | $65,625 | ||
| Provider Capacity Unlocked | Additional patient visit capacity | (210 minutes saved/day ÷ 20 min visit) × 250 days | 2,500 visits |
| Maximum Revenue Capacity** | Revenue potential from added capacity | 2,500 visits × $130 | $325,000 potential revenue |
| Revenue Stream Enabled | Insurance-covered visits | 8 visits/day × 250 days | 2,000 visits |
| Insurance-reimbursement revenue | 2,000 visits × $130 | $260,000 annual revenue enabled |
**Maximum revenue capacity reflects the total patient volume the practice could support with the operational efficiencies unlocked by Tebra, while insurance billing revenue represents a new reimbursable payment model now available to the practice.
Products used in this case study
Insights for independent healthcare practices
