Establishing and sustaining a healthy medical practice requires the use of cutting-edge technology and up-to-the-minute knowledge of billing, collections and coding regulations. This is why, when I receive a call from a provider who wishes to establish a new practice—either solo or in a group setting—the first thing required is a dedicated Tax ID Number that is used for billing and contracting. Some providers come in with old TINs or single LLCs that may not work in a group setting, so during setup I encourage them to speak to their CPA for advice on how best to set up this portion of their practice.
Once we have a TIN, they will need an Organizational NPI. They must register through the NPPES NPI Registry. Our service usually does this piece for them.
Physicians then need a corporate bank account into which Medicare money and other money may be deposited. If they are using their own bank and not a billing company’s recommended bank account, they will need a letter from the bank verifying the validity of the account and a banker’s name and phone number on bank stationery. This letter will accompany the application to Medicare.
The next step is credentialing and contracting for those health plans in which they wish to participate, which includes Medicare, Medicaid and their plans, etc.
Once these steps are completed, billing can begin. From start to finish, the startup process to bill in-network may take six months to a year. Under different scenarios, out-of-network billing may begin very quickly if needed, but it depends on the type of practice.
