Your first practice, without the first-year revenue mistakes.
Opening or joining a practice after training comes with a timeline nobody teaches: credentialing that takes 90 to 180 days, contracts with billing hidden in the fine print, and first claims that decide your first six months of cash flow. Here is the order to do things in.
Count back from your start date
Everything below is measured against the day you see your first patient. The earlier steps are the ones that cannot be rushed later.
Adds real dates to each step. Stays in your browser only.
- 180 to 120 days before
Credentialing starts
Payer enrollment takes 90 to 180 days. Apply the day your start date is known, not the day you start. CAQH profile, state license, DEA, malpractice and NPI must all match.
- 120 to 90 days before
Contracts and setup
Employment or partnership contract reviewed. Compensation, tail coverage, non-compete and who pays for credentialing are written down. Tax ID, group NPI and bank account for the practice are in place.
- 90 to 60 days before
Systems and payers
EMR, clearinghouse and ERA enrollments. Fee schedule loaded. Decide who bills: in-house, a service, or a mix.
- 60 to 30 days before
Follow up on every application
Every payer application gets a follow-up call at 30 days. Missing signatures and expired documents are the usual reasons an application sits.
- 30 days before
Front desk and templates
Eligibility checks, copay collection, referral tracking and the visit templates you will actually use. Staff trained on the workflow, not just the software.
- First 30 days
First claims and first report
Claims go out daily from the first visit. Rejections are corrected the same day. At day 30 you get a report: charges, submissions, denials by cause.
Six things that cost first-year practices the most
Each one is avoidable with a date on a calendar and a name next to it.
Seeing patients before enrollment is effective
Visits before the payer effective date are often not payable at all. Check each payer's effective date before the schedule opens.
Letting the practice sign a contract that says "credentialing handled" without a date
Ask who submits, when, and who follows up. Put it in writing.
Skipping the fee schedule review
Contracts with allowed amounts below cost are hard to fix later. Compare the top 20 codes against your expected volume before signing.
One person holds all the logins
Payer portals, clearinghouse and CAQH access should be documented and shared with a second person from the start.
Waiting for the first denial to learn the rules
Prior authorization and referral rules for your top payers are known before the first visit, not after the first denial.
No monthly report from day one
If nobody reconciles the schedule against claims each week, unbilled visits disappear quietly. Set the cadence before volume grows.
Two downloads and a free class for your staff
Written for physicians who are about to sign, not for billing companies.
The First Practice Guide
Contracts, tax ID and group NPI, systems, payers, front desk setup and the first 30 days, in one checklist with dates.
Download the guideCredentialing timeline
Which payer applications to file when, what each one needs, and the 30-day follow-up script that keeps them moving.
Download the timelineFree clinic staff training
Three live classes for your front desk and new staff: EHR management, coding basics and billing basics, certificate included.
See the free classesCredentialing first, billing from the first visit
We file and follow up every payer application with a status you can check, set up billing so claims go out from day one, and build the practice website patients actually use. Published prices, no long contract.
Starting in the next twelve months?
Book a call and we will put your dates on the timeline together. No cost, no obligation.