1. Check your state and your market
Confirm your state's rules for CRNA practice and whether it has opted out of Medicare physician supervision. Then look at demand: surgery centres, offices and rural hospitals that need anesthesia coverage.
2. Form the business
Choose a structure with a healthcare lawyer and an accountant. Most groups form a professional entity owned by the CRNAs. Get a tax ID and a business bank account in the group's name.
3. Get your group NPI and enroll with payers
Apply for a group NPI, then enroll the group and each CRNA with Medicare, Medicaid and commercial payers, and set up reassignment so payments go to the group. Enrollment often takes a few months, so start early. See payer enrollment for CRNA groups.
4. Insurance and policies
Arrange malpractice cover, general liability and workers' compensation if you have employees. Put basic clinical, privacy and documentation policies in writing.
5. Sign facility contracts
Agree coverage, call, stipends if any, and who bills for what. Check how each facility's payer mix will affect your income. See what to check in CRNA contracts.
6. Set up billing before your first case
Decide who will bill, set up electronic claims and payments, and agree how anesthesia records reach your biller. Plan for the gap between your first case and your first payment.
7. Track your numbers from month one
Watch collection rate, days to payment and denials from the start. Problems are cheapest to fix early.
This article is general information, not billing, legal or tax advice. Payer rules change; always check current guidance.
Sources
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