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Practice Start-up

Whether you are establishing a solo practice or joining a group, beginning the practice of medicine requires considerable forethought. You have to weigh options and proceed carefully because there's a lot at stake. This is particularly true for the physician launching his/her own medical practice as this is probably the most significant professional decision he/she will make since deciding on a specialty.

Marc H. Bailey & Associates will develop a well-planned time line which is individualized for your particular circumstances whether joining an established group or partnership or starting your own solo practice. This time line focuses on the business side of medical practice. The listed activities/tasks associated with each phase of the time line will enable you to move efficiently through the maze of practice start-up procedures and meet all of the statutory regulations and requirements for medical practice. Ideally, the process should begin at a minimum of one year before your transition into private practice.

Shown below is a partial listing of generic start-up activities for a typical solo medical practice:

  1. Determine the legal structure for the practice (sole proprietorship, partnership, PC, LLC, etc.) and file the appropriate state and Federal documents.
  2. Determine whether a bank loan will be necessary (practice start-up costs range from $100-150K for a typical internal medicine solo practice).
  3. Prepare a business plan with financial forecasts (required for a commercial loan).
  4. Locate appropriate office space and negotiate office lease and tenant improvements.
  5. Obtain state medical license and DEA number.
  6. Obtain Federal and state tax ID numbers.
  7. Complete provider applications for Medicare, Medi-Cal, Blue Cross, Blue Shield, and other third parties to obtain provider numbers.
  8. Apply for hospital privileges and IPA membership(s) to gain access to PPO and HMO contracts.
  9. Obtain professional liability, general liability, Workers' Comp, etc. insurance coverage.
  10. Obtain medical and office equipment (decide on lease vs. purchase).
  11. Purchase/lease office computer system and decide on applications (billing and collection, insurance processing, accounting, practice management, patient scheduling, word processing, clinical applications, applications for managed care, electronic medical records, etc.).
  12. Establish fee schedule.
  13. Determine accounts payable chart of accounts.
  14. Hire staff, set salary ranges, prepare job descriptions, set up personnel files, prepare performance appraisal forms, etc.
  15. Prepare employee handbook with personnel policies and procedures.
  16. Prepare office operations policies and procedures.
  17. Develop compliance plans for meeting HIPAA, CMS (Medicare) fraud and abuse, OSHA and CLIA requirements.
  18. Develop a strategic marketing plan.

As noted, this list is only a sampling of the practice start-up activities and tasks. Marc has developed a more comprehensive ten-page list of start-up tasks which must be accomplished at various points prior to opening your new medical practice. Marc will review this list of tasks with you at the initiation of the project to tailor a plan of work with appropriate time lines. This review will determine those specific tasks with which you will require assistance and those which you will accomplish on your own.

Working together with Marc H. Bailey & Associates your practice start-up will receive the careful consideration and planning required for a smooth and less stressful transition into private practice. Getting it right will yield enormous rewards in both your professional and personal life.

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Marc H. Bailey and Associates • 5013 Butterfield Court • Culver City, CA 90230 • Tel. 310.838.9170 •