Starting a successful medical practice is doable and offers many advantages, such as autonomy and having the ability to make business decisions affecting the practice independently. Despite all the changes occurring in healthcare, owning your own practice is still the best way to go. Let Doctors Business Network help you setup your practice! Below we have grouped the actionable items needed to opening your practice in steps 1 to 7. Within each step you will see actionable items you need to complete before opening your doors. Many of these steps have a detailed explanation linked to them, in video and written format. Follow the link to watch the relevant video for that topic.
Over the years, through successes, failures, trials, tribulations, gambles and experience, we have devised the following steps to assist in starting a medical practice:
- Step 1
- Step 2
- Step 3
- Step 4
- Step 5
- Step 6
- Step 7
- Step 8
- Step 9
- Step 10
- Step 11
- Step 12
- Step 13
- Step 14
Organizational and Support
- Finding a Bookkeeper, Payroll Company, Legal Firm, Accounting Firm, Start-Up Consultant, Insurance Agent/Broker
- Evaluate organizational options
- Selection of Entity and Entity Formation
- Coordinate entity name reservation/fictitious business name filing
- Obtain Federal Tax I.D. number
- Select a date to begin practice
- Finalize and execute recruitment contract, if applicable
- Structure Buy/Sell Agreement if a group practice
- Structure Employment Agreement & Employee Handbook
- Negotiate withdrawal from existing practice, if applicable
- Physician Compensation Model and Employment Agreements, if group practice
- Register for state and local tax identification numbers
- Apply for business license in the area(s) of practice, State and Local
- Choosing a Bookkeeper, Accounting Firm, Payroll Company
Location Analysis and Space Planning
- What are your location options
- Conduct location analysis
- Determine space requirements
- Select location
- Negotiate lease terms
- Office lease reviewed by legal counsel
- Execute office lease
- Design office layout
- Evaluate space plans
- Prepare construction documents
- Obtain competitive bids
- Review Owner-Contractor Agreement
- Construction administration
- Complete room by room fixed asset needs list
- Interior Design
- Coordinate Move-in
- Coordinate Signage
Credentialing and Privileging Issues
- Determine present participation in plans & hospital privileges
- Submit applications for hospital privileges
- Obtain managed-care provider applications or notify of change on provider status
- Submit credentialing application to desired commercial & government insurance entities
- Prepare Medicare and Medicaid provider application
- Complete and mail managed-care provider applications or notify for existing practice
- Obtain membership in state medical association
- Obtain membership in county medical society
- Obtain/transfer state medical license
- Obtain/transfer state narcotic license
Mediacl Office Insurance
- Purchase malpractice insurance
- Purchase group health insurance/dental insurance
- Purchase liability insurance Purchase Workers' Comp insurance
- Purchase Employee Practices Liability
- Purchase disability coverage
- Purchase employee fidelity bond coverage
State and Federal Compliance
- Develop OSHA compliance
- Develop CLIA compliance
- Develop HIPAA compliance
- Develop Stark compliance
- Develop environmental and occupational safety program
- Coordinate Employee and Physician compliance training
Financial Planning, Accounting and Billing
- Prepare cash flow projection
- Prepare furniture & equipment budget (see location planning above)
- Determine loan financing requirements
- Prepare loan request summary
- Select banks to submit loan request
- Determine banking services needed
- Present loan summary to banking institutions
- Negotiate loan/services
- Prepare and review personal financial statement
- Open practice checking account
- Coordinate merchant credit card account
- Purchase credit card machines
- Set up accounting system and related training
- Set up practice internal controls
- Decide on petty cash policy
Fees and Coding
- Review usage of evaluation & management codes
- Develop office charge ticket
- Develop hospital charge ticket, if applicable
- Development of practice fee schedule
- Conduct CPT and ICD-10 training
Computer/Software Selection or Billing Service
- Define hardware & software requirements (e.g. PPM, EMR, imaging)
- Select qualified billing service company
- Select qualified vendors
- Prepare requests for proposal
- Coordinate demonstrations
- Evaluate proposals
- Negotiate purchase agreement
- Negotiate service agreement
- Coordinate installation
- Coordinate conversion
- Coordinate system set-up (e.g. Payer codes, payer classes)
- Finalize computer training schedule and implementation timeline
- Make sure all employees are adequately on new computer system
Telephone System Selection/Communications
- Define hardware needs (e.g. voice mail)
- Determine lines/features needed (e.g. cable modem/DSL)
- Obtain telephone number
- Coordinate remote call forwarding
- Coordinate installation of lines
- Select vendors for bids
- Evaluate bids
- Order equipment
- Select answering service
Other Equipment Planning
- Review Needs
- Prepare furniture & equipment budget
- Determine acquisition schedule
- Submit major items for bid
- Evaluate bids
- Order office furniture
- Order medical record filing systems
- Obtain quotes and order photocopier/fax machine
- Obtain quotes/order transcription equipment
- Obtain quotes/order examination room equipment
Marketing Planning
- Draft medical office marketing plan
- Develop office branding and positioning
- Develop logo and marketing material
- Create and purchase letterhead/business card design
- Select open house date
- Plan details of open house
- Create and submit grand opening announcements
- Create PPC copy and banner ads
- Develop website & submit to search engines
- Create social media accounts
- Submit office details to online directories
Operatoins, Procedures and Policies
- Prepare office policy and procedures manual
- Prepare bank deposit procedures
- Prepare daily financial close-out procedures
- Prepare daily/monthly financial reporting
- Prepare appointment scheduling procedures
- Prepare billing and accounts receivable follow-up guidelines
- Prepare upfront collection guidelines
- Prepare adjustment guidelines
- Prepare periodic audit and office assessment schedule
- Prepare accounts payable procedures
Human Resources
- Determine clinical and administrative staff positions
- Create job descriptions and salaries
- Implement payroll services
- Create human resources policy manual
- Develop the recruiting process
- Create employee benefit package
Good luck and enjoy your new practice!
Doctors Business Network is here for you every step of the way! Come back and enjoy the coupons and discounts, competitive marketplace, CME class discounts or if you just have a questions visit out Viseo Q&A Library. When The Practice Of Medicine Becomes The Business Of Medicine. Remember Doctors Business Network!
