Medical Office Start-Up Checklist

The process of starting a medical office can be a difficult task. But with the proper planning, you can have your medical office up and running effectively and efficiently. The decisions you make now are crucial as you set your goals regarding every aspect of your medical office. Here is a list of items and processes that can be used to start-up a new medical office, relocate, join, or reorganize an existing one.

Organizational Items

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  • Select a date to begin practice
  • Legal representation, accounting firm and medical practice startup consultant selection
  • Determine organizational structure
  • Entity name selection and formation
  • Obtain federal, state, and local tax identification numbers
  • Develop employment agreements and physician compensation model
  • Determine startup budget
  • Prepare furniture and equipment budget
  • Obtain financing

Medical Practice Location and Setup

Doctor walking in office hallway
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The location and space you will occupy require a search and planning and will have an impact on all of your other decisions and budget. Take into account the opportunity for future expansion.

  • Perform location analysis
  • Determine space requirements
  • Select location
  • Negotiate the terms of the lease
  • Evaluate the space plans and design the office layout
  • If building, prepare construction documents
  • Submit request for bids
  • Sign owner-contractor agreement
  • Design and furnish each room
  • Obtain indoor and outdoor signage

Credentialing and Hospital Privileging

Surgeons in discussion walking through hospital
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Your office and providers will need to be credentialed by insurers and hospitals. As this process can take three to six months, it should start well in advance of when you need it to be complete.

  • Obtain state medical license
  • Obtain DEA license
  • Obtain state narcotic license
  • Submit provider enrollment and credentialing applications
  • Obtain membership in state medical association
  • Obtain membership in county medical society
  • Submit applications for hospital privileges


Health insurance helps patients get the medical care they require
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A variety of insurance will be needed for the medical office. Shop for the best prices and coverage.

  • Purchase malpractice insurance
  • Purchase group health insurance/dental insurance
  • Purchase liability insurance Purchase Workers' Comp insurance
  • Purchase Employee Practices Liability
  • Purchase disability coverage
  • Purchase employee fidelity bond coverage


Doctor working at laptop in clinic office
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Are you meeting all of the regulations governing the medical office? Build compliance into your startup process so you won't be delayed by any violations.

  • Develop OSHA compliance
  • Develop CLIA compliance
  • Develop HIPAA compliance
  • Develop Stark compliance
  • Develop environmental and occupational safety program
  • Coordinate Employee and Physician compliance training

Financial Planning and Accounting

Businessman using calculator
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You need to start the office on a sound financial footing with accepted practices and procedures.

  • Prepare cash flow projection
  • Prepare and review personal financial statement
  • Open practice checking account
  • Purchase credit card machines and open merchant credit card account
  • Set up accounting system and related training
  • Set up medical office internal controls
  • Establish a financial policy

Billing and Coding Setup

Medical Bill
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The financial success of your medical office depends on accurate billing and coding.

  • Develop fee schedule
  • Determine evaluation and management codes to be used
  • Select collection agency
  • Create registration, encounter, and HIPAA notice of privacy practices forms
  • Establish medical record filing system
  • Purchase HCFA forms
  • Develop patient info booklet
  • Obtain Medicare billing manual
  • Obtain Medicaid billing manual
  • Purchase CPT and ICD-9 books
  • Purchase specialty-specific coding book(s)

Computer Hardware and Software System

Doctor checks computer monitor.
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The right automation can enhance patient scheduling, documentation, billing, and coding.

  • Define hardware and software requirements
  • Evaluate and select qualified vendors
  • Purchase billing software, electronic health record (EHR) software, and practice management system
  • Purchase computer and other office equipment
  • Coordinate installation and system set-up
  • Create computer training schedule and implementation timeline
  • Setup training timeline for new computer system

Communication System

Just one moment please
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Efficient patient flow through the medical office depends on your communication systems.

  • Coordinate telephone setup
  • Order telephone equipment
  • Select answering service
  • Select paging service

Other Equipment and Supplies

Doctor taking patients blood pressure in examination room
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You will need to assess and acquire clinical equipment as well as office equipment and ensure a reliable supply chain for expendables.

  • Purchase photocopier, transcription equipment and fax machine
  • Purchase examination room equipment
  • Purchase laboratory equipment
  • Purchase other clinical equipment
  • Purchase break room furniture, refrigerator, and microwave
  • Purchase initial stock of medical supplies

Marketing Plan

Yellow marker emphasizes 'Marketing' in a printed document
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You've built it, but will the patients now come? A marketing plan will launch your new medical office for success.

  • Draft medical office marketing plan
  • Develop logo and marketing material
  • Create letterhead/business card design
  • Purchase business cards
  • Purchase office stationery
  • Select open house date
  • Plan details of open house
  • Create and submit grand opening announcements
  • Create newspaper and yellow pages ads
  • Develop website

Office Operations

Employee Handbook and Forms
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Procedures, policies, and guidelines allow your staff to operate efficiently and stay within regulatory guidelines.

  • Prepare office policy and procedures manual
  • Prepare bank deposit procedures
  • Prepare daily financial close-out procedures
  • Prepare daily/monthly financial reporting
  • Prepare appointment scheduling procedures
  • Prepare billing and accounts receivable follow-up guidelines
  • Prepare upfront collection guidelines
  • Prepare adjustment guidelines
  • Prepare periodic audit and office assessment schedule
  • Prepare accounts payable procedures

Human Resources

Intern nurse and doctor working in nurses office
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Your medical office is only as good as the staff. Create the system that will select and support them.

  • Determine clinical and administrative staff positions
  • Create job descriptions and salaries
  • Implement payroll services
  • Create human resources policy manual
  • Develop the recruiting process
  • Create employee benefit package
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