Back in 2017, I wrote a blog called “First 10 Steps to Starting a Private Practice.” Today’s blog post is an updated version that highlights the priority steps to starting a private practice and also incorporates additional resources.
Please note that this blog post is just of my experience with starting a private practice in Pennsylvania, USA. All information is for educational purposes only.
1. Get an EIN – The EIN is your federal tax ID number that is used to identify your business entity. Generally businesses need this. You can apply for your EIN for free on the IRS website and you get the EIN immediately. Before starting the online form, make sure you know which address you will want to associate with the EIN, what your business name will be (if practicing under a different name than your own) and the type of entity you will go with (like sole proprietor or LLC). Be sure to check your individual Department of the State website to see what regulations are in place. For more information on business structures. For more information on the EIN.
2. Get Your NPI – The NPI (or National Provider Identifier) is a unique, 10 digit, ID for covered health care providers. If you are planning to accept insurance as a provider, you will need to get an NPI. It only takes a few minutes to apply for an NPI online. There are two different types of NPI: type 1 is an individual NPI and type 2 is an organization NPI. I have a Type 2 NPI for my LLC and a Type 1 NPI for me as an individual provider. For more information on the NPI. To apply for an NPI.
3. Get Professional Liability Insurance – Professional liability insurance (PLI) is insurance that can protect you as a health care professional against claims initiated by clients for negligence. When choosing your liability insurance, think about your scope of practice, the services you are going to provide, and the amount and type of coverage you need. If you are a member of the Academy of Nutrition and Dietetics, they offer Dietitians a discount for Proliability by Mercer. For more information on Proliability.
Additional Steps to Take if Planning to Accept Insurance
4. Set-up your CAQH profile – CAQH ProView is an online credentialing database that basically helps to eliminate duplicating paperwork that you will provide for insurance companies. Some information you will provide on this form includes: personal provider information (like your address and education), mailing address, business EIN, professional licenses, business hours of operation, liability insurance paperwork, etc. For information on CAQH ProView.
5. Apply for Each Insurance – Once you have the CAQH set-up and approved, you can start the application process for each individual insurance company. Most insurance companies have a link on their website that says, “join our network,” or “become a provider.” A lot of insurances are using online forms that include a spot for your CAQH number. Once your application is approved, you will be contacted for credentialing and contracting. This can take several weeks (or months) so get started early!
While becoming an insurance provider can be a complex and time-consuming process, it allowed me to expand my referral sources (i.e. connect with other health care providers like physicians) and grow as a practice since my services were more accessible to clients.
What to Do Next?
At this point, you can start to work on the other steps involved in building a private practice like:
- Deciding on payment policies and procedures – blog link
- Deciding how you will see clients (in-office or virtually) – blog link
- Building your online presence (blogs, social media, web design)
- Creating your practice paperwork (new client forms, consent forms, policies, privacy notices, etc.)
- Building partnerships – blog link
Disclaimer: Information provided is not intended to constitute legal or medical advice. All information is for educational purposes only.