Entity, licensing & tax setup
LLC or PC formation, EIN, state licensure, DEA registration, malpractice coverage and banking — coordinated with your attorney and CPA.
08 · Practice Start-Up
Practice Start-Up & Management
Opening a practice is a hundred small decisions with long consequences. We make them in the right order, so the doors open on time and the first claim gets paid.
Engagement at a glance
- Engagement modelFixed-fee launch project plus optional monthly operations support
- PlanOne master plan with owners, dates and dependencies
- CadenceWeekly launch call with a written decision log
- HandoverDocumented SOPs and a 90-day post-opening review
- VendorsWe negotiate directly with EHR, billing, supply and staffing vendors
- ReportingMonthly P&L, volume and revenue reporting from month one
90 days
Typical launch runway
From engagement to first patient seen, when the provider is already licensed.
Day 1
Billing readiness
Fee schedule, payer contracts and clearinghouse live before the first visit.
30+
Launch workstreams
Legal, licensing, credentialing, technology, staffing, finance, compliance and marketing.
The problem
Build it once, build it right.
The most expensive mistakes in a new practice are made before it opens: the wrong entity structure, a lease that does not allow build-out, a fee schedule copied from someone else, payer contracts signed without negotiation, and credentialing started three weeks before the first appointment.
We run the launch as a project with a single plan and a named lead. Entity and tax setup, NPI and licensing, malpractice, banking and merchant services, space and equipment, EHR and practice management, fee schedule and charge master, payer contracting, staffing and onboarding, policies and compliance infrastructure — sequenced so nothing blocks anything else.
Once you are open, we stay for the first 90 days as your operating layer: managing the schedule build, the billing ramp, the staffing plan and the monthly financial reporting, then handing over a practice with functioning systems rather than a stack of good intentions.
What's included
Everything in this service, in writing.
Payer contracting
Direct contracting with commercial payers and Medicare, fee schedule negotiation, and enrollment of the group and each provider.
Fee schedule & charge master
A defensible fee schedule built from your payer mix and market, mapped to your charge master and reviewed annually.
EHR & practice technology
Requirements, vendor demos, contract review, implementation, data migration, and clearinghouse and e-prescribing setup.
Staffing & workflow design
Org chart, job descriptions, hiring, front-desk and MA workflows, scheduling templates and phone handling.
Policies & compliance foundation
HIPAA policies and training, OSHA exposure control, clinical and administrative SOPs, and a compliance program proportionate to size.
How it runs
The engagement, step by step.
01
Feasibility & plan
Market, payer mix, volume and staffing assumptions modelled into a pro forma with a realistic break-even month.
02
Build workstreams
Legal, licensing, technology, space, staffing and compliance run in parallel against one plan with weekly status.
03
Contract & credential
Payer contracts negotiated and applications filed early, because enrollment is the longest pole in the tent.
04
Open & operate
Dry-run workflows, staff training, go-live support, and 90 days of operations management with monthly reporting.
What we hold ourselves to
These are the operational targets we report against for this service. They are industry benchmarks and internal commitments — your results depend on your volume, payer mix and specialty, and we will tell you honestly where you should expect to land.
90 days
Typical launch
Day 1
Billing readiness
30+
Workstreams managed
3–6 mo
Typical break-even
FAQ
Common questions.
I am leaving a group — when should I start?
Twelve months before you open is ideal, six months is workable, and anything under 90 days means making compromises on payer contracts and hiring. The single longest lead time is payer enrollment, so that starts first.
Do you help with the business plan and financing?
Yes. We build the pro forma, volume and staffing model, and the operating narrative that banks and equipment lenders ask for. We do not lend money and we are not a broker.
Can you run the practice for me?
We provide the operating layer — billing, credentialing, HR, supplies, compliance and financial reporting — under your ownership and clinical leadership. We are not a management services organisation taking equity in your practice.
What does a launch cost?
Launch projects are fixed-fee and scoped by workstream, typically in the range of a few months of a practice manager's salary. We give you the number before you commit and we do not take a percentage of your revenue to open your doors.
What about a second location?
Same playbook, faster. We reuse the entity, credentials and payer contracts, and focus on the physical site, staffing and scheduling build.
Related services
Often bought together.
EHR Implementation & Practice Technology
EHR and PM selection, implementation and migration, interface and interoperability work, automation, reporting and security.
- Vendor-neutral selection — we do not sell software
- Implementation, data migration and staff training
- Interfaces, automation, reporting and security hardening
Telehealth, RPM & Chronic Care Programs
Program design, device logistics, patient enrollment, care plans and compliant billing for telehealth, remote monitoring and chronic care management.
- Compliant CCM, RPM and PCM program build and billing
- Device kit logistics, enrollment and consent handled
- Care plans, monitoring workflows and documentation that stand up
Medical Billing & Revenue Cycle Management
Charge capture, clean-claim submission, denial work-down, payment posting and A/R follow-up — run by a dedicated team on your existing practice management system.
- Clean-claim rate and first-pass acceptance reporting
- Denial prevention, appeals and underpayment recovery
- Aged A/R worked to a written escalation ladder
Talk to someone who has run this before.
Thirty minutes with an operations lead who works this service every day. Bring your numbers if you have them; we will tell you what we see either way.
A 30-minute call with an operations lead. No obligation, no sales sequence, and we will say so if you do not need us.