> ## Documentation Index
> Fetch the complete documentation index at: https://www.practiceownersguide.com/llms.txt
> Use this file to discover all available pages before exploring further.

# The Practice Owner's Guide

> The reference for physicians, dentists, and clinician-owners. From first entity to final exit: forming the entity, borrowing, credentialing, getting paid, and deciding whether to scale or sell.

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.

<Note>
  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](https://getlemma.com), 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](https://mso.getlemma.com).
</Note>

## Who this is for

| You are | Start with |
| - | - |
| Planning your first practice | [Launching your practice 101](/start-here/01-launching-your-practice-101) |
| An owner who wants to see where the money goes | [How your practice gets paid](/start-here/02-how-your-practice-gets-paid) |
| An office manager or biller | [What is an 835?](/concepts/what-is-an-835) and the [payer directory](/reference/payer-enrollment-directory) |
| Buying or expanding | [Buying a practice](/guides/buy-a-practice) |
| Thinking about groups, MSOs, or selling | [Scaling beyond one practice](/guides/sell-or-scale) |

## 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.

```mermaid theme={null}
%%{init: {'themeVariables':{'fontFamily':'inherit','fontSize':'14px'}}}%%
flowchart TB
    subgraph r1 [" "]
        direction LR
        S["Start Here"] --> F["Form"] --> U["Fund"] --> B["Build"]
    end
    subgraph r2 [" "]
        direction LR
        P["Get Paid"] --> O["Operate"] --> C["Scale"] --> E["Exit"]
    end
    B --> P
    style r1 fill:none,stroke:none
    style r2 fill:none,stroke:none
```

<CardGroup cols={3}>
  <Card title="Start Here" icon="compass" href="/start-here/launch-in-4-months">
    Orient, see the four-month launch map, and pick your practice model.
  </Card>

  <Card title="Form" icon="building" href="/guides/choose-your-entity">
    The entity and CPOM, ownership agreements, licenses, insurance, and hiring.
  </Card>

  <Card title="Fund" icon="sack-dollar" href="/guides/get-a-practice-loan">
    Startup costs, practice loans, buying a practice, and the lease.
  </Card>

  <Card title="Build" icon="screwdriver-wrench" href="/guides/choose-your-ehr">
    Your EHR, clearinghouse, front-desk stack, banking, payroll, and HIPAA.
  </Card>

  <Card title="Get Paid" icon="money-bill-transfer" href="/guides/get-credentialed">
    Credentialing, payer setup, EFT/ERA, patient payments, and how insurance money moves.
  </Card>

  <Card title="Operate" icon="gauge-high" href="/guides/practice-kpis">
    KPIs, bookkeeping, the tax and compliance calendars, and associate comp.
  </Card>

  <Card title="Scale" icon="arrow-up-right-dots" href="/guides/associates-vs-partners">
    Partners, a second location, going out of state, and the MSO structure.
  </Card>

  <Card title="Exit" icon="door-open" href="/guides/sell-your-practice">
    Selling your practice and planning succession.
  </Card>

  <Card title="Reference" icon="table-list" href="/reference/owners-task-repo">
    The owner's task repo, checklists, state-rule tables, the payer directory, and the glossary.
  </Card>
</CardGroup>

## Contents

### Start Here

* [Launch in four months](/start-here/launch-in-4-months): the whole sequence on one page
* [Launching your practice 101](/start-here/01-launching-your-practice-101), [how your practice gets paid](/start-here/02-how-your-practice-gets-paid), and [setting up your banking](/start-here/03-setting-up-your-banking)
* Practice models: [insurance](/concepts/practice-models-insurance), [cash-pay](/concepts/practice-models-cash-pay), [telehealth](/concepts/practice-models-telehealth), [hybrid](/concepts/practice-models-hybrid)

### Form

* [Choose your entity](/guides/choose-your-entity) and [entity and tax basics](/guides/entity-tax-basics); [CPOM and the PC](/concepts/cpom-and-the-pc)
* [Ownership agreements](/guides/ownership-agreements) and [owning without a license](/guides/own-a-practice-without-a-license)
* [Licenses and permits](/guides/licenses-and-permits), [malpractice and insurance](/guides/malpractice-and-insurance), [hiring W-2 vs. 1099](/guides/hiring-w2-vs-1099)

### Fund

* [Startup cost calculator](/reference/startup-cost-calculator) and [worksheet](/reference/startup-costs)
* [Get a practice loan](/guides/get-a-practice-loan) and [loan options](/guides/practice-loan-options)
* [Buy a practice](/guides/buy-a-practice), [deal mechanics](/guides/buy-a-practice-deal-mechanics), and [negotiate your lease](/guides/negotiate-your-lease)

### Build

* [Choose your EHR](/guides/choose-your-ehr), [clearinghouse](/guides/choose-your-clearinghouse), and [front-desk stack](/guides/front-desk-stack)
* [Setting up banking](/start-here/03-setting-up-your-banking) and [account structure](/concepts/practice-banking-structure); [payroll and benefits](/guides/payroll-benefits-retirement); [HIPAA in one week](/guides/hipaa-in-one-week)

### Get Paid

* Set up payers: [credentialing](/guides/get-credentialed), [CAQH](/guides/caqh-setup), [Medicare/PECOS](/guides/medicare-pecos-enrollment), [Medicaid](/guides/medicaid-enrollment), [contracting](/guides/payer-contracting), [EFT/ERA](/guides/enroll-eft-era), and [switch banks](/guides/switch-banks)
* Patient payments: [POS](/guides/choose-your-pos), [patient responsibility](/guides/patient-responsibility), and [financing](/guides/patient-financing)
* How insurance money moves: [claim lifecycle](/concepts/claim-lifecycle), [what is an 835?](/concepts/what-is-an-835), [ERA vs. EOB](/concepts/era-vs-eob), [denial codes](/concepts/carc-rarc-denial-codes), and [reassociation](/concepts/eft-reassociation)
* Money operations: [work your denials](/guides/work-your-denials), [lockboxes](/concepts/lockboxes), [reconciliation](/concepts/reconciliation), [month-end close](/guides/month-end-close), and [patient refunds](/guides/send-patient-refunds)

### Operate

* [Practice KPIs](/guides/practice-kpis), [bookkeeping and tax calendar](/guides/bookkeeping-and-tax-calendar), [compliance calendar](/guides/compliance-calendar), and [associate comp models](/guides/associate-comp-models)

### Scale

* [Scaling beyond one practice](/guides/sell-or-scale) is the map; then [associates or partners](/guides/associates-vs-partners), [open a second location](/guides/open-a-second-location), [expand out of state](/guides/expand-out-of-state), [become an MSO](/guides/become-an-mso), and [multi-entity money](/guides/multi-entity-money)

### Exit

* [Sell your practice](/guides/sell-your-practice)

### Reference

* [The Owner's Task Repo](/reference/owners-task-repo), [checklists](/reference/checklists), and [forms library](/reference/forms-library)
* State rules: [CPOM by state](/reference/cpom-by-state), [telehealth by state](/reference/telehealth-by-state), and [entity types by state](/reference/entity-types-by-state)
* [Payer EFT/ERA enrollment directory](/reference/payer-enrollment-directory) and [glossary](/reference/glossary)

## Next

<Card title="Launching your practice 101" icon="arrow-right" href="/start-here/01-launching-your-practice-101">
  The map. Read it once before doing anything, because the expensive mistakes come from doing steps in the wrong order.
</Card>


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