What's on it
Work through this from the top. Enrollment takes the longest, so start it as early as you can.
Decide and plan
- Confirm your state's supervision rules and whether it's an opt-out state
- Pick the facilities you'll start with and talk to their surgeons
- Estimate volume, payer mix and how much cash you need to get started
- Choose a healthcare lawyer and an accountant
Set up the business
- Form your entity (LLC, PLLC or corporation, as your state requires)
- Get an EIN and open a business bank account
- Get a group NPI (Type 2) and confirm each provider's individual NPI
- Set up an operating agreement if there's more than one owner
Insurance
- Malpractice cover for every provider, at the limits your facilities require
- General liability and cyber cover
- Tail cover sorted for anyone leaving a claims-made policy
Enrollment
- Medicare enrollment for the group and each provider
- Reassignment of each provider's benefits to the group
- Medicaid and each Medicaid managed care plan you'll see
- Commercial payer credentialing and CAQH profiles
- Electronic payments (EFT) and remittances (ERA) set up in the group's name
Facilities and billing
- Signed anesthesia services agreement with each facility
- Agreed process for getting anesthesia records to billing every day
- Billing partner or system in place before the first case
- Fee schedule set for every payer
Cash and reporting
- Cash set aside to cover pay and costs until claims start paying
- Monthly report agreed: collections, days in A/R, denials
- Calendar of licence, certification and revalidation dates