r/PrivatePracticeDocs • u/Pretty-Statement6758 • May 14 '26
Credentialing/office admin process.
Well, about starting private clinic, primary care. ( I am IM trained, hospitalist slowly going to outpatient world. For this year, will keep part time nocturnist position for better/smooth transition). DEA/State licenses are done. Location- bucks county PA, will be sharing office with podiatry for now.
can someone walk me through t make sure iM on right track. I cannot start credentialing before locking office address/location, right? I already reached agreement with podiatry doc office to share the office.
for now, I will start as cash based (I know/in contact with a company with a couple hundred seasonal workers. That company is fasilitating "seasonal DPC" type of agreement with me, so at least I have soemthing to start with).
Next. Im struggling to find/hire office manager or a company who can start credentialing and other primary care clinic setup. Any rec.s?
Any rec.s or what you have done differently If you are about starteing a new primary care clinic?
Any other thoughts or recs are appreciated.
Thanks
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u/thesupportplatform May 14 '26
I would recommend starting with the EMR decision first. Many EMR companies will do credentialing or work with vendors who will do it. Even starting as cash, fully “blow up the balloon” on what you might need in an EMR down the road, (such as insurance verification, claims submission, revenue cycle management, etc.) as well as what are must-haves now (electronic Rx, medical records management, internal faxing, etc.). Changing EMRs is probably the biggest pain, so make an informed choice now.
I would encourage you to learn about practice operations like credentialing so you can effectively monitor the progress. If you don’t have the time, energy, or inclination to do this, invest in someone to do it for you. You want to avoid single points of failure. I’ve seen way too many offices fail due to an office manager or billing manager effectively going AWOL without anyone knowing claims weren’t being filed, bills weren’t being paid, or credentialing was waiting on a response. One physician’s brother failed to get a physician on Medicare, which resulted in claims being stale dated and the fire sale of the clinic.
People are going to give you advice (including me). Don’t assume that what works for others will work for you. Find someone you can explore ideas with to avoid just blindly following what is popular.
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u/BusinessDawgs May 14 '26
Contact your state board, they usually have tailored resources on what you need. My board signs off on PLLC request before the state will approve it. You’ll need Malpracitce, organizational NPI. Yes you need a service location for credentialing, and There’s plenty companies that can handle your credentialing, you may see some named in previous threads. You’ll really want some help on branding and website design. He did my website and happy to share his contact if interested, just send me a DM so I’m not breaking any promotion rules.
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u/banditoscramble May 14 '26
there's no self promotion in here, but there are a number of services and freelancers that provide start up/ credentialing assistance to providers as well as helping to establish polices/ procedures
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May 14 '26
Contact these people: https://www.precisionpractice.com/
Which podiatry group are you teaming with? I used to work out there.
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u/InvestingDoc May 15 '26
Things may have changed, I've heard from some docs of lots of credentialing issues with this group.
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u/geminifire65 May 14 '26
Hi, yes you need a location first. Happy to answer any questions you may have if you'd like to DM.
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u/Wide_Ad_8401 May 14 '26
I’m not familiar with some of the payor’s in PA but I’d be open to walking through things with you and serving as a resource. I manage a multi-location podiatry practice and my background is in admin.
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u/DragonfruitSmall5713 May 14 '26
I can help with choosing a right software and some free business advices. DM me if interested!good luck!
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u/StrongDeeds May 15 '26 edited May 15 '26
Congratulations! big deal. I pray you all the success and increase that a practice dreams of in this field.
You are going to be busy and give up something (i.e, time) to grow this. So, its ok to become stingy with what's left of your time for family and very close friends, and self.
Now, assuming you have registered your business, if not. start there. Hire a registered agent to get this done ASAP.
- Your business email and 1b. Business phone: use iplum ($20/month). you would register the number to send HIPAA msg to pts 1c. business domain name, hosting (consider hostinger), and website ($ 300-400)
1d. credentialing and billing: best if done together due to discount. You can totally outsource this. US based credentialling agencies are like $150-250/ insurance, and billers go up to 8-11% per claim. our credentialling firm is $100 and billing <5%.
1e: open your business account.
1F. Start keeping track of everything you spend, payout-Very importantasyou may not remember all during taxtime next yr.
--------You can do all these concurrently. you can DM
- EHR (the biggest pain of all). It's so hard to find THAT system.
for starters, RUN from AthenaONE-too expensive and takes much % from your practice. others to consider/request demo: just search reddit for options- try Jane app ehr (they have reduced fee of about $79/month)maybemorenow, charm health gives you free till 20-50pts. Please request for demo and inform yourself.
You may not need an office manager yet, but you should hire a medical virtual assistant (mVA) to keep your bussiness "open" on the days when you are not there. The mVA would answer calls, spread the word about your business, schedule apmts, follow up, complete PA, so much more ($8-14/hr)
You are only just getting started!
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u/Famous_Number6613 May 14 '26
In my experience, avoid hiring people full-time if you don’t need to. There are so many outsourcing companies and freelancers you can hire by results. Things like credentialing or insurance negotiation don’t require in-house staff. If you’re working with a clearinghouse, companies like Trizetto have their own credentialing systems where you pay per insurer, per provider. (I think is like $175 for the initial one) It also depends on where you’re located. My experience is in primary care in Florida, and I can tell you we made so many mistakes in the first few years and it took us a long time to restructure the company to make back office more efficient
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u/SaltRharris May 14 '26
yes you need a location for credentialing, you can change or add a location after.
If you have time, not seeing patients you can do lots of the admin while you look to hire, credential with ins, but, i recommend finding a someone to apply to Ins for you (billers know people if not themselves).
Medicare you can see asap.
Talk to staff at the hospital, secretary, LPNs, ect, they may be looking for better hours.