We get questions about setting up a new practice fairly regularly. There are people that offer turnkey services for this, but we don’t. We can help with several aspects of the operations, strategy, and marketing areas. But, we suggest hiring a consultant that does practice start-up. MGMA can be a great resource and we can recommend local consultants in several markets like Dallas-Fort Worth and San Diego. Below is a checklist to help think through some of the items for a new practice.

Administrative Setup

  • Decide fully independent vs affiliation vs employment
  • Determine Legal Structure (discuss with attorney and accountant) and file with state. If you need recommendations on a board-certified healthcare attorney, we have several that are fantastic.
  • Select accountant and accounting software
  • Tax ID, NPI, DEA, & DPS
  • Sales Tax Certificate (depending on state requirements)
  • Bank Accounts
  • Insurance
    • General Liability
    • Cyber Liability
    • Employment Practices Liability
    • Business Interruption
    • Workers Compensation
    • Health/Disability/Life/Dental/Vision
    • Malpractice
  • Create Policies/Procedures/Protocols Manual
  • Evaluate IPA and ACO membership
  • Evaluate local (Chamber) and business organization membership – We can help with selecting the right organization to get the best return on investment.
  • Hospital Privileges
  • Credentialing with payors – start this as early as possible, preferably 6 months out

Office Selection & Setup

  • Site Selection
  • Sign lease – Review with real estate attorney or at least a broker.
  • Building Finish Out
  • Certificate of Occupancy
    • Fire Inspection
    • Safety Inspection
    • City Inspections
  • Furnishings/Supplies
  • Set Office Hours – We recommend starting with generous hours allowing patient slots before work, during lunchtime, and/or after work.
  • Signage – Get these in early – both interior and exterior. We can recommend solid sign vendors.

Equipment & Technology

 • Practice Management & Billing Software
• Electronic Health Records
• Phone System
• Hardware
• Internet

Business Planning

  • Marketing Plan including website, social, online profiles, business card, brochure, signage, forms, prescription pad, outreach to potential referral sources, community outreach, press release, and advertising. More details on all of these can be found here, including how to do a lot of marketing for under $100.
  • Strategic Plan/Goal Setting


  • Financial Plan/Budget
  • Develop Fee schedule
  • Negotiate rates with payors (use managed care professional) if not utilizing IPA rates. Consider a fractional managed care person if contracting directly. We may have resources that can help depending on specialty.
  • Establish Patient Financial Policy
  • Select coding books/software (unless built into EMR)


  • EMR
  • Document Destruction
  • Medical Waste
  • Laboratory
  • Credit Cards
  • Janitorial Needs
  • Office Supplies
  • Maintenance


  • Job Descriptions – We can share samples.
  • Employee Handbook (policies/requirements) – We have resources for this if you need help.
  • Hire Staff
  • Train Staff
    • OSHA
    • Stark
    • CLIA
    • HIPAA
    • Universal Protocol Training
  • Obtain & Post Required Posters  (i.e., OSHA, Equal Pay, etc.)
  • Benefits enrollment – We know several fantastic brokers in different markets.
  • Payroll Service – If you find one you love, please share. We haven’t found one we love, but have found several that are tolerable and are happy to share information.

We’d love to add to this list with your must-do items for new practices.