New Practice Setup Services: From Formation to First Claim

Everything a New Practice Needs Before Its First Insurance Claim

Opening a practice involves a dependency chain most founders discover too late: entity and EIN, Type 1 and Type 2 NPIs, malpractice coverage naming the new entity, CAQH ProView, Medicare (855I + 855B + 855R), state Medicaid, and every commercial payer — each step gating the next. ProEnrollment's new practice setup service runs this entire chain as one coordinated project, so your effective dates land near your open date instead of a quarter after it.

What the Service Includes

Entity-stage guidance (NPI registration, taxonomy selection, NPPES accuracy), complete CAQH build with the new practice address, the full Medicare form set filed together, state Medicaid and MCO applications, simultaneous commercial submissions to your target payer list, weekly follow-up on every application, and written effective-date confirmation before you bill. For a physician projecting $30,000/month in insurance revenue, starting this on entity-formation day instead of opening week is worth $60,000-$90,000 in recovered revenue.

Timeline and Getting Started

Typical zero-to-credentialed timeline: 90-120 days with simultaneous submission — against 9-12 months sequential DIY. See a real outcome: new practice case study. Related: new practice credentialing | launch checklist | cost calculator | free consultation.