Skip to main content
Owning a practice means running two businesses: a clinical one and a financial one. Training covers the first. Almost nothing teaches the second, and most of what exists online is vendor marketing. This guide covers the financial and operational side: forming the entity, borrowing, credentialing, choosing systems, understanding how insurance money actually reaches your account, buying and expanding practices, and deciding whether to scale or sell.
Every legal and payer claim carries a citation to a primary source. Where a rule is unsettled or varies by state, we say so. Maintained by Lemma, a banking platform for healthcare practices. Product mentions live in clearly marked asides. For MSO, DSO, and corporate practice of medicine topics, see the companion MSO-PC Wiki.

Who this is for

How the site is organized

The guide follows the arc of practice ownership. Each tab is a phase, left to right: orient, then form, fund, build, get paid, operate, and eventually scale or exit. Jump to the phase you’re in. Reference sits alongside as the lookup layer you keep coming back to.

Start Here

Orient, see the four-month launch map, and pick your practice model.

Form

The entity and CPOM, ownership agreements, licenses, insurance, and hiring.

Fund

Startup costs, practice loans, buying a practice, and the lease.

Build

Your EHR, clearinghouse, front-desk stack, banking, payroll, and HIPAA.

Get Paid

Credentialing, payer setup, EFT/ERA, patient payments, and how insurance money moves.

Operate

KPIs, bookkeeping, the tax and compliance calendars, and associate comp.

Scale

Partners, a second location, going out of state, and the MSO structure.

Exit

Selling your practice and planning succession.

Reference

The owner’s task repo, checklists, state-rule tables, the payer directory, and the glossary.

Contents

Start Here

Form

Fund

Build

Get Paid

Operate

Scale

Exit

Reference

Next

Launching your practice 101

The map. Read it once before doing anything, because the expensive mistakes come from doing steps in the wrong order.