Complete Practice Launch Guide
Billing and Credentialing for a New Practice
Complete Practice Startup & Billing Setup Guide
A roadmap for opening your own practice: credentialing, billing setup and compliance, in order.
4-8%
Our billing fee, as a share of collections
$150
Our credentialing fee, per application, per provider
60-90 Days
Credentialing timeline per payer
Why Choose Medtransic for Your Practice Launch?
We specialize in helping new practices get off the ground quickly and profitably. Our launch package includes everything you need for billing success from day one.
Your Practice Launch Timeline
Pre-Launch (3-6 Months Before)
- Business entity formation and tax registration
- Obtain NPI numbers (individual and organizational)
- Apply for or confirm your state license
- Secure malpractice insurance
- Choose and contract with EHR/PM system
- Begin payer credentialing process
Setup Phase (2-3 Months Before)
- Complete CAQH profile for all providers
- Submit credentialing applications to major payers
- Set up billing and coding workflows
- Establish your fee schedule
- Configure clearinghouse connections
- Develop compliance and privacy policies
Launch Preparation (1 Month Before)
- Train staff on billing procedures
- Test claim submission workflows
- Set up patient registration processes
- Configure eligibility verification
- Establish payment processing
- Conduct compliance training
Go-Live and Beyond
- Begin seeing patients and submitting claims
- Monitor claim submission and payment posting
- Track key performance indicators
- Address initial denials promptly
- Refine workflows based on results
- Complete remaining credentialing applications
Essential Services for New Practices
Provider Credentialing
Complete credentialing with Medicare, Medicaid, and commercial payers
- CAQH profile setup and maintenance
- Application submission to all major payers
- Follow-up and status monitoring
- Typical timeline: 60-90 days per payer
- Re-credentialing every 2-3 years
Billing System Setup
Configure practice management and billing workflows.
- EHR/PM system selection and implementation
- Fee schedule configuration
- Clearinghouse integration
- Payment posting automation
Compliance Foundation
Establish policies and procedures for regulatory compliance
- HIPAA privacy and security policies
- Compliance training for staff
- Business Associate Agreements
- Incident response procedures
- Regular compliance audits
Revenue Cycle Setup
Build efficient processes for maximum revenue capture
- Eligibility verification procedures
- Point of service collection policies
- Denial management workflows
- Patient billing and statements
- A/R management processes
Common Startup Mistakes to Avoid
Starting Credentialing Too Late
Cannot bill a payer until enrollment with it is complete, so early visits go unpaid
Begin credentialing well before opening. In our experience it usually takes 60 to 90 days with each payer.
Underestimating Startup Costs
Cash flow problems in the first months
Budget for the gap between your first visits and your first insurance payments.
Poor Front-End Processes
High claim denial rates, delayed payments, patient frustration
Invest in staff training for registration, eligibility verification, and authorization management from day one.
Inadequate Technology
Manual inefficiencies, coding errors, billing delays
Choose proven EHR and practice management systems with strong billing capabilities and clearinghouse integration.
No Compliance Program
Risk of audits, fines, and legal liability
Establish HIPAA policies, compliance training, and documentation standards before seeing patients.
Trying to Do Everything In-House
Overwhelmed staff, billing errors, owner burnout
Partner with an experienced billing company for credentialing, billing, and collections, and focus on patient care.
Ready to Launch Your Practice?
Get a free consultation with our practice launch specialists. We will create a customized timeline and budget for your specific situation, and show you how to avoid the expensive mistakes most new practices make.