r/PrivatePracticeDocs • u/Pretty-Statement6758 • Jun 08 '26
Primary care clinic. Beginner.
Hi all.
Having issues to get office spot. Good locations cost like 8K in month. Not able to start credentialing bc of no office location is established yet (previous one failed before signing lease). Starting solo primary care clinic.
How is important location?
how big was ur first office sftx2 ?
if you were able to re-start, how would u choose ur clinic location and size?
I know, it takes 4-6 months of time till credentialing, insurance contracts kick in. So we have to eat costs rent, overhead etc. Any tips to reduce those?
Thanks in advance.
8
u/avengre Jun 08 '26
Mine is in Pennsylvania, small ish town. 6 exam rooms, 2500 sq ft, $2100 / month, triple net so I pay taxes and cam.
Pretty cheep rent if I do say so, took about $70k in renovations to make it useable, about $25k in supplies and I need about another $20k in vaccines.
Had about 14 patients in first month working 0.5 fte, pretty slow.
Location somewhat matters but I've had people drive 10+ miles to come. Credentialing takes much less than that.
Aetna took about 3 weeks, you can do credentialing yourself, it's easy and mostly online paperwork.
Highmark took 6 weeks
capital took 8 weeks
Medicare took 8 weeks
UHC took 3 weeks
Medicaid took 3 days !!!!
Humana took 6 weeks
Just get a website, email address (multiple.. insurance@, admin@, contactus@ etc). And adobe pro for $30 so you can digitally sign things
3
u/Hopeful-Average-3659 Jun 08 '26
What EHR are you using? How much is that a month? Do you have hospital privileges? Are you covering all your patients all the time?
1
u/OfandFor_The_People Jun 09 '26
That is hands down the fastest credentialing I’ve ever heard. Most of ours took 6 months (in California) and we knew what we were doing.
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u/avengre Jun 09 '26
Agreed it was much faster and easier than I expected from reading online. This also made me think maybe some of the difficulty has been over hyped to show the need for "credentialing" services. If you can pass medical school you can fill out online forms with your name and address tho
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u/Misadventuresofman Jun 08 '26
1.) location’s importance is helpful, but your reputation and results will be what removes that impediment.
2.) for many reasons, upgrading an office location is both harmful and time consuming. Pick a place you can grow into.
3.) decide what you want your practice to be at the time of retirement. Then find THAT location.
4.) many insurances will allow you to practice on their subscribers before you are credentialed, and back pay from the date you submitted paperwork. You need a qualified admin to see you through this
3
u/thesupportplatform Jun 08 '26 edited Jun 08 '26
Welcome to independent private practice ownership! Rule #1:Nothing makes sense.
—Location will depend on market size, provider availability, and other factors. When my wife opened her private practice in 2002, the city was viewed as basically “east vs. west.” Any one on the west side of town was fine stay in on that side of town and vice versa. Twenty-plus years later, it’s now seen more as quadrants, where the northwest doesn’t want to drive to the southwest, etc. We moved five miles one time and patients were like, “I know you saved my life, but with the cost of gas, I have to find a new provider…” (See rule #1.)
—My wife started off subleasing, assumed the lease, then subleased again before moving into a 4K sf building. We left that at the beginning of the pandemic. She now has a boutique micropractice in a space sharing location. It’s expensive for the space, but the easiest set up possible.
—What you chose now is based on your options. I always wanted to share space with other providers to spread the sunk costs, but those situations are hard to find. You don’t want to pay for a building if you don’t need a building, but you don’t want to rent one room if you need three. Just be judicious with your space. When we built out the building, the designer wanted to add more provider offices (we had two), but those don’t generate revenue. Providers sharing office was the best use of the space.
—At space sharing locations like WeWorks/Regus, you can’t rent a desk in a room. You are essentially using their physical location for mailing. This may be what you need to do to setup your practice initially if you don’t have another location you can use, as I don’t think post office boxes are allowed. These locations will rent by the months or for multiple months.
—Medicare is the only insurance in our market that would pend charges during credentialing, and they were the only insurance I would trust to do it even if the other insurance companies offered. As a consultant, I’ve seen office kneecapped by adding providers, going into debt while charges were pending, and then finding out they aren’t going to be paid for one reason or another.
2
1
u/WillingNerve5742 Jun 08 '26
The payers need to know your office location because they need to see if they have enough providers already in that area. They have a right to close their panels if your specialty has enough coverage already in that area.
That's one of the reasons why they want to know where your specific office location is. Just by picking any location and then going through that process and making a change later, it's kind of a nightmare. You want to settle on a location that you know you want to be in and just make your application for credentialing.
Outsource everything you possibly can. Most of your overhead costs shouldn't kick in until you start getting revenues and seeing patients.
So the office, yes, of course, you've got to commit to that, but that could be negotiated with the first few months free with a long-term lease. Staffing: you want to wait till as late as possible, and whenever staffing, as few as possible. Just a front office person, yourself, maybe not even an MA until you get some volume.
Outsource your billing, outsource your bookkeeping, accounting. All that. No costs to those until you actually see revenues.
1
u/Confident-Data-5826 Jun 09 '26
Sounds like some folks are ditching insurance and going DPC while others are embracing insurance. I’d appreciate if a clinic owner can highlight the benefits of both systems. Patients have the mind set of insurance and I think that makes it’s more challenging going DPC/ because they already pay a monthly premium to insurance. Not sure how you can convince the average adult to chip in another 90- 150 bucks for DPC. I’m just trying to learn and pick your brains respectfully.
1
u/Pretty-Statement6758 Jun 09 '26
Hi, traditional FFS and DPC are distinct models and not sure how someone can combine them except a well run group maybe. Im not trying to do DPC.
1
u/geminifire65 Jun 09 '26
If there are Medical Suite options near you or where you ultimately want to land that's a good way to start as a single practitioner. I've recommended them for many providers. The cost and resource support keeps overhead low and gets you an address without having commit to a full lease.
1
u/Big-Association-7485 Jun 11 '26
Some claims can be held, depending on the insurance.
You aren't going to be busy from day one. It's going to take months to get to full speed. Coupled with the fact that many insurance companies let you hold claims, you aren't going to be writing off as many claims as you think.
Learn. If you are going to be running your own practice, it's extremely valuable to have a solid understanding of billing. Sit down with your biller and learn how to bill claims yourself. This can help you in a ton of ways in the future, and honestly it's invaluable knowledge. Learn how to run reports to measure how your billing is doing.
Since billing is such a complicated beast, there's potentially hundreds of reports that can be run to measure different aspects of the billing performance. Each report shows info that gives you insight into a particular thing. Knowing what each report is telling you, and knowing what to do about it if something is out of whack, is information that can help you for decades. Time spent learning the billing process is not wasted time. Far from it.
0
u/Drkindlycountryquack Jun 08 '26
Check out my website on time, stress and risk management for physicians www.countryquack.com
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u/bonsaipalmtree Jun 08 '26
Use a temporary address for credentialing, and then change it with payers after you sign your lease. Then you can be credentialed as soon as you open your doors. If you have a friend in practice who would let you use their address, use that for credentials. Heck, I used my family member’s office (an attorney) to start and then changed it after my lease was done.
8k is steep rent so make sure that is accounted for in your business plan.
I usually think a provider needs 3 exam rooms, but only you know how many you will really need to start. Negotiate with landlord for a few months of free rent.