1. You will want to start getting ready about 90-180 days before you actually open.

2. First step should be to visit with an attorney about the best tax structure/liability shelter to organize your business under and obtain a tax id (EIN). In most states, this corporate structure will be either an S Corporation or an LLC.

3. After you have received your EIN/Tax ID, you will want to go on to NPPES and obtain an NPI for your new business entity. This is an easy process and you should have an NPI back within about 2 business days of submitting your information. You will not need an individual NPI number, since you already have one. NPI’s are like SS numbers-one per person regardless of where they work.

4. You will want to start an application with Medicare via the PECOS system (on-line). I do not recommend a person filling out the paperwork. Takes too long, paperwork gets lost/thrown away, etc. You will want to do an application for the following:

a. 855B-this is for your corporate entity and allows you to obtain a PTAN. You will also want to fill out a 460 (Par Provider sheet) and a 588 (Electronic Funds Transfer/Direct deposit)

b. 855I-this is for you personal PTAN. Unlike NPI’s, you might have multiple PTANs depending on how many DIFFERENT companies you work for. Because you are establishing a new business, you will need this new PTAN to link to the new business.

c. 855R-Reassignment of Benefits. This tells Medicare that you want all of your payments to be sent to the entity listed in the 855B-Group number. So payments will not come to Kolby Watts, they will go to ABC Therapy, INC and be taxable to ABC.

5. Locate CAQH, a free credentialing organization. They handle credentialing for you with a variety of national payers.

6. If CAQH does not handle BCBS, you will want to credential with BCBS of Kentucky. Since this is usually the largest commercial payer in all 50 states, you want to make sure you make credentialing with them a priority and do it sooner than later.

7. If you are going to treat Medicaid patients, you will need to credential with the state and then all of the individual Privatized Medicaid plans you would like to work with.

8. Identify space to lease for clinic (you can use your home when you begin the credentialing process, so it is not critical that you have an office until you are ready to open. NOTE: if you do not have clinic space when you credential, you will need to update Medicare, CAQH and any other insurances that require unique credentialing processes BEFORE you begin to treat. Otherwise, your claims might suspend or deny payment because the address isn’t registered. This is one of those Catch 22 situations.

9. Work with a bank to obtain financing for clinic build out (if necessary) and a Line of Credit.

10. Talk with someone about Malpractice coverage (PTOne which I think was recently renamed as VGM Insurance is often mentioned by PTs as a good insurer).

11. If you decide to go with a Revenue Cycle Management Company (like RMS), make sure they experience with PT billing. Over the years we have seen a number of practices come to us from Mom and Pop types of billers that have all sorts of Medical clients, dental clients, etc. Each medical specialty has its own set of quirks. You don’t want to go out of business while your biller is trying to figure out what is wrong. Also, look for an RCM that has EMR/Scheduling/Billing integrated. It makes a difference.

12. Pray