Your Step-by-Step Roadmap
Follow these steps in order. This keeps your setup “credentialing-ready” and prevents delays later when you start contracting with payers.
Start With Your State License
This Is Your First Step to Practicing
Your state license is the gateway to starting your private practice. Nothing else can move forward until it is in place.
If you do not yet have a license in the state where you plan to establish your practice, we can help you obtain it while managing all the complexities of the process for you.
➡ Learn more about our licensure services
Obtain Board Certification (When Applicable)
Board certification is often required for physicians and nurse practitioners to qualify for insurance credentialing. If you are not yet certified or are board eligible, it’s not a no. Some insurance providers may still proceed with credentialing depending on their specific policies.
Apply for Your DEA Number
If you are a mental health provider or plan to prescribe controlled substances, obtaining a DEA number in the state where you will practice is mandatory.
Do not have one yet? We can handle the entire process for you, so you can focus on building your practice.
Apply for Your State CDS Permit (If Required)
In some states, a separate State Controlled Dangerous Substances (CDS) permit is required in addition to your DEA registration.
If you need one, we can handle the application process for you and make it simple.
Build a Credentialing-Ready Resume
Your resume is one of the first things payors will review, so it is essential to have it clean, accurate, and formatted correctly. Make sure all dates follow the MM/YYYY format, as insurers are very strict about this.
Your resume should include:
- ➡ Education with dates
- ➡ Professional experience with dates
- ➡ Certifications
- ➡ Licensure details
- ➡ Any special training
A well-prepared resume helps streamline the credentialing process and makes a strong first impression with payors.
Keep Your Degree or Diploma Handy
Many payors, especially for nurse practitioners, require a copy of your Master’s Degree or Diploma.
- ➡ Keep a clear, scanned copy ready from day one
- ➡ Make sure it is legible and complete for credentialing purposes
Having your degree or diploma prepared early helps avoid delays in your credentialing and application processes.
Get Your NPI (National Provider Identifier)
Your NPI is your unique National Provider Identifier. You receive one NPI as an individual, and you may obtain multiple NPIs for your business if needed.
➡ If you do not have an NPI, you can apply here:
NPPES
➡ If you are unsure how to obtain it, we can help you get it at no cost
Having your NPI ready is essential for credentialing and billing purposes, so make sure it is in place before moving forward.
Create or Update Your CAQH Profile
CAQH serves as the digital credentialing hub used by almost every private insurance company. Keeping your profile complete and current is essential for smooth credentialing.
➡ Create or access your profile here:
CAQH
➡ Ensure your profile is 100% complete
➡ Upload all required documents
➡ Keep your attestation current
➡ Forgot your login? We can help you retrieve it
A well-maintained CAQH profile helps prevent delays with insurance credentialing and ensures your information is always up to date.
Decide How You Want to Practice
You can either start as a Sole Proprietor for a quicker, simpler setup or form a Business such as an LLC, PLLC, or Corporation for a more structured, long-term approach.
Option A: Sole Proprietor (Simpler and Faster)
You will need the following to get started
➡ A malpractice insurance that covers professional liability
- Nurse Practitioners may get one from CM&F or NSO
- Physicians can get it from MedPro, TDC, or others
➡ A voided check with your name printed on it Or a bank letter with your account details
Option B: Form a Business (LLC, PLLC, Corporation, etc.)
You will need all of the below to get credentialed as a business.
➡ Articles of Incorporation or Organization
➡ EIN letter from the IRS
➡ Business bank account
➡ Business checks with the business name printed on them exactly as it appears on the EIN letter
➡ Malpractice insurance for both you individually and your business (or list your business as an “additional insured on your individual policy”)
Choose Your Office Setup
Decide whether you will operate a physical brick-and-mortar practice or a telehealth clinic, as this will impact your setup and costs.
Option 1: Physical Office
➡ Consider a small medical suite or a health center space if you are just starting out
➡ Helps keep costs down while you build your practice
Option 2: Telehealth Practice
Even for a telehealth-only practice, use a virtual office instead of your home address, especially for mental health providers
➡ You can get a virtual office from providers such as:
- Regus
- Opus Virtual Offices
Get a Phone & Fax System
Your practice must be easily reachable by patients and other providers.
➡ Set up a reliable phone and fax system
➡ We recommend RingCentral, a VOIP system you can use from your computer or mobile device
Start the Credentialing Process
Congratulations! You have completed all the prerequisites for your private practice. The next step is to begin the insurance credentialing process so you can attract new patients, receive payments without disruptions, and build your provider panel.
➡ The credentialing process typically takes 3–4 months
➡ If you are new to credentialing, we have helped thousands of providers across the nation
➡ Learn more about our credentialing services
Choose Your EHR (Electronic Health Record)
Selecting the right EHR is essential for running your practice efficiently. Choose a system that includes practice management features so you can:
➡ Check patient eligibility
➡ Submit claims
➡ Schedule appointments
➡ Document clinical notes
Some of the most commonly used EHRs include:
➡ Tebra
➡ eClinicalWorks (eCW)
➡ SimplePractice
➡ AdvancedMD
➡ NextGen
Choose the EHR that best fits your workflow, specialty, and practice needs.
Get Help With Administrative Tasks
Once you are credentialed and have your EHR in place, you need to decide how you will handle daily administrative tasks, including:
➡ Scheduling appointments
➡ Checking patient eligibility
➡ Managing patient communication
➡ Handling intake forms
You can manage these tasks yourself, or hire a Virtual Assistant to take care of them while you focus on building your practice or working with patients.
➡ Learn more about our Virtual Assistant services
Hire a Biller or Billing Service
Proper billing is essential to keep your practice financially healthy. A dedicated biller ensures claims are submitted accurately and on time, insurance reimbursements are received without delays, and your revenue cycle runs smoothly.
➡ Decide whether to hire an in-house biller or outsource to a professional billing service
➡ A biller can handle:
- Claim submission and follow-up
- Insurance verification and eligibility
- Payment posting and reconciliation
- Managing denied or rejected claims
Outsourcing billing can save time, reduce errors, and let you focus on patient care instead of paperwork.
➡ Learn more about our Billing Services
Run Your Practice and Take Charge
Congratulations! With licensing, credentialing, office setup, EHR, administrative support, and billing in place, your private practice is ready to operate.
➡ Manage your day-to-day operations confidently
➡ Oversee patient care, scheduling, and communications
➡ Monitor claims, payments, and financial health
➡ Expand your practice or hire additional staff as needed
You are now your own boss, and every decision is in your hands. With the foundation built, your focus can be on growing your practice, providing excellent care, and achieving your professional goals.
Planning to Start Soon?
Tell us your specialty, state(s), and whether you’re launching as a sole proprietor or a business—then we’ll map the fastest path to get you licensed, credentialed, and revenue-ready.
Quick Answers Before You Launch
These are the most common questions we hear from physicians and nurse practitioners starting a new private practice. If you want help with setup, our team can support licensing, credentialing, and billing so you can launch faster.
Start with your state license in the state where you plan to practice. Then secure your NPI and build/update your CAQH profile before beginning payer enrollment. If you need help, see our licensure services.
Most payers take 3–4 months depending on specialty, state, and panel status. We manage submissions and follow-ups end-to-end — learn more on our credentialing service page.
If you are credentialing and billing as a business entity (LLC, PLLC, corporation), you typically need a Type 2 (organization) NPI. Individual clinicians use a Type 1 NPI. You can apply through NPPES.
- State license (and DEA/CDS if applicable)
- Credentialing-ready resume (MM/YYYY date format)
- Malpractice insurance (and general liability if credentialing as a business)
- EIN letter + W-9 + voided check (for business credentialing/EFT setup)
- Degree/diploma (commonly requested for NPs)
Choose your EHR early so your workflows are ready, but expect to start in-network billing after payer approvals and effective dates. If you want to outsource revenue-cycle tasks from day one, explore our billing services and eligibility verification.
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