> ## 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.

# Launching your practice 101

> The map for opening a practice, in the right order — the expensive mistakes come from doing steps out of sequence.

This page is the map. Each step links to a full recipe. Read it once before doing anything, because the expensive mistakes come from doing steps in the wrong order.

## The critical path

<Warning>
  **Payer credentialing takes 90 to 180 days, and you can't start it until you have an entity, an NPI, and usually an address.** Everything else can compress. Credentialing can't. Practices that open before it completes either see patients they can't bill for, or sit idle paying rent.
</Warning>

```mermaid theme={null}
gantt
    dateFormat  YYYY-MM
    axisFormat  M%m
    section Foundation
    Entity, EIN, banking, loan       :a, 2026-01, 2M
    section Credentialing
    Credentialing + contracting (the long pole) :crit, 2026-03, 6M
    section Build
    Lease, build-out, equipment      :2026-03, 5M
    EHR selection + implementation   :2026-05, 3M
    section Open
    Hiring, test claims, soft open   :2026-08, 3M
```

## Step 1: Form the entity

Most states require a professional entity (PC or PLLC) owned by a licensee, because of corporate practice of medicine doctrine. Entity form and tax election are decisions for a healthcare attorney and a CPA. Re-forming later means re-credentialing, so get it right once.

→ [Choose your legal entity](/guides/choose-your-entity) · [Why: CPOM](/concepts/cpom-and-the-pc)

## Step 2: Get the identifiers

In order: EIN from the IRS, then a Type 2 (organizational) NPI from [NPPES](https://nppes.cms.hhs.gov/), then a CAQH profile, then PECOS if you'll see Medicare patients. Your individual Type 1 NPI identifies you on claims; the Type 2 identifies the billing entity.

→ [Get credentialed](/guides/get-credentialed)

## Step 3: Get the money

Practice lending is a friendly market: defaults are rare, so lenders compete for you. Options are SBA 7(a), bank practice-finance divisions, and specialty lenders. Fund the build-out, equipment, and at least 6 months of working capital to cover the credentialing gap.

→ [Get a practice loan](/guides/get-a-practice-loan) · [Startup costs](/reference/startup-costs)

## Step 4: Open the bank accounts

Same week the EIN arrives. Every later step points at these accounts: loan disbursement, payer EFT enrollments, payroll. Changing accounts later means re-enrolling with every payer, so the account you pick for payer deposits is a long-term decision.

→ [Setting up your banking](/start-here/03-setting-up-your-banking)

## Step 5: Sign the lease and build out

Negotiate the healthcare-specific terms: tenant improvement allowance, exclusivity, and assignment rights (these matter when you sell). Have the healthcare attorney read the lease.

## Step 6: Choose the EHR

A ten-year decision disguised as a subscription. Vendors demo the clinical side; practices bleed on the billing side. Evaluate on claims quality, 835 ingestion, and data export.

→ [Choose your EHR](/guides/choose-your-ehr)

## Step 7: Contract with payers, enroll EFT/ERA

Credentialing gets you approved. Contracting gets you rates. EFT/ERA enrollment gets money and remittance data flowing electronically. Payers must offer ACH EFT when you request it (45 C.F.R. § 162.1602). Enroll both during onboarding, not later.

→ [Enroll in EFT and ERA](/guides/enroll-eft-era) · [Payer directory](/reference/payer-enrollment-directory)

## Step 8: Test, then open

Before opening day, run a test claim through the full cycle for each top payer: submit, receive the 835, watch the deposit land, reconcile the two. Broken billing configuration discovered in week three costs a month of silent failures.

→ [The claim lifecycle](/concepts/claim-lifecycle)

## Next

<Card title="How your practice gets paid" icon="arrow-right" href="/start-here/02-how-your-practice-gets-paid">
  Open up the machine that most of your revenue arrives through.
</Card>