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Medical Billing

Setting Up Billing for a Brand-New Practice

The sequence matters. Enrollment and credentialing gate everything, so building the billing workflow first wastes the months that actually mattered.

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2 min read · by White Glove Medical Billing
Foundation footings poured before any framing

New practices build the visible things first — the space, the system, the website — and discover that the invisible thing they skipped is the one with a lead time measured in months.

The correct order

  1. Entity and identifiers. Business registration, tax identification, and an organizational NPI. Everything else depends on these.
  2. Credentialing and payer enrollment. Start immediately. This is the longest lead time by a wide margin and it gates all revenue.
  3. Practice management system. Chosen once you know which payers you will bill.
  4. Clearinghouse and ERA/EFT enrollment. Per payer, after enrollment approves.
  5. Fee schedule. Set above your highest contracted allowable, with a separate self-pay rate.
  6. Front-end workflow. Eligibility, estimates, collection at the desk.
  7. Billing workflow. Last, because it cannot function before the rest exists.

The mistake that costs most

Seeing patients before enrollment completes. Claims for an unenrolled provider deny, retroactive windows rarely cover a full delay, and in many cases the patient cannot be billed either. Those months are not recoverable.

The cash reality

Even done correctly, first collections arrive well after first patients. Enrollment, then the billing cycle, then the payment cycle. A practice that budgets for revenue from month one runs out of money in month three.

The one thing to do this week

If you are opening and have not started credentialing, start it now. Nothing else on the list has a lead time you cannot compress, and nothing else determines your earliest billable date.

Denials Piling Up?

We handle the revenue cycle end to end — coding by certified coders, claim submission, denial management and appeals, and A/R follow-up, with six reported numbers every month.

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