New Practice Startup
Opening a practice is a build project with a cash-flow clock running behind it. Every week between your first patient and your first paid claim comes out of your own pocket, and most of the delay is not clinical — it is payer enrollment that started too late, a billing system configured after go-live, or a service line that opened before it was credentialed.
We build the whole business infrastructure and then run it, so the practice opens with its revenue cycle already working rather than being assembled around it.
What we build
- Entity and Licensure: Formation, EIN, licensing, facility requirements, insurance and the policies and procedures a new practice is expected to have on day one.
- Payer Enrollment and Credentialing: Medicare, Medicaid and commercial enrollment sequenced so the highest-volume payers are live first, tracked to an approval date rather than a submission date.
- Technology Stack: EHR selection and build, practice management configuration, clearinghouse setup, interfaces, and the reporting you will run the business from.
- Front Office and Workflow: Scheduling templates, intake, verification, prior authorization and patient communication — designed before opening rather than patched afterward.
- Staffing and Training: Role definition, sourcing, onboarding and training, with offshore capacity where it lowers cost without lowering quality.
- Revenue Cycle from Claim One: Coding standards, charge capture, denial prevention and A/R discipline in place before the first claim goes out, not after the first denial arrives.
From Decision to First Paid Claim
A launch is a sequence, not a list. Work done in the wrong order costs weeks of revenue at the point when the practice can least afford it.
- Before the lease: Entity, tax ID and NPI first, because payer enrollment cannot start without them. Payer panel agreed and applications sequenced by expected volume. This is where most launches lose their first month.
- Build, 60 to 90 days out: EHR and practice management configured, clearinghouse connected, fee schedules loaded, coding standards set. Front office, scheduling templates and staffing model designed before anyone is hired into them.
- Go-Live: Doors open with enrollment tracked to approval dates, claims tested before the first real one goes out, and a named owner running the launch to a weekly cadence.
- First paid claim and beyond: Denials worked at the point of origin, A/R discipline from day one, KPI reporting live — and we keep running it rather than handing over a binder.
Where launches actually slip
Most delayed launches trace back to the same handful of causes, and all of them are avoidable with sequencing:
- Payer enrollment started after the lease was signed rather than before.
- A service line opened before its credentialing was complete, generating claims nobody could collect.
- The billing system was configured after go-live, so the first month of claims went out wrong.
- No one owned the launch full-time, so it moved at the speed of whoever had a spare afternoon.
The Fortuna HCS difference
Most launch support ends at advice. We run the launch as a project with a named owner, a sequenced plan and a weekly cadence — and we stay afterward to operate what we built. The practice opens with its revenue cycle already working rather than being assembled around it.