New Practices
New Practices
Medical Billing Solutions for New Practices
A Practical Guide for Physicians Launching Clinics
Opening a New Practice? Don’t Let Billing Complicate Your Start
Physicians who set out to open independent practices often do so with a clear goal: deliver quality care without the red tape of hospital systems. But even before the first patient visit, one issue quickly surfaces, how to get paid. Medical billing, payer credentialing, and claim management are complex even for experienced operations teams. For new practices with no internal billing staff, this becomes a risk area that directly threatens financial stability.
If you’re a psychiatrist starting your own therapy office, a nurse practitioner launching a primary care clinic, or a physician leaving a group to establish a solo practice, billing is not just paperwork. It’s survival.
The First Barrier: Credentialing Delays That Stall Revenue
Most physicians underestimate how long it takes to get credentialed with commercial payers and government insurance. The average timeline ranges from 90 to 180 days, depending on the state and payer type. During this window, no claims can be submitted. You’re treating patients, but your revenue clock hasn’t started.
We’ve seen new practices sit idle for months, waiting on Blue Cross or UnitedHealthcare to finalize enrollment.Without proactive monitoring and follow-up, delays in credentialing can result in unrecoverable thousands of dollars in lost revenue.
Low Patient Volume Doesn't Mean Low Complexity
Most billing firms like larger, high-volume clients. Startup practices, however, typically have 5 to 15 patients a week during the initial stages, which does not lower billing complexity. Each visit still has to be documented, coded, submitted, and followed up on properly.
In specialties such as family medicine or psychiatry, CPT coding, session documentation, and time-based modifiers are paramount. Denials can result from even slight errors, incorrect place of service, missing authorization, or incomplete demographics.
The Common Denial Traps for New Clinics
Industry-wide claim denial rates are increasing, particularly for new startups. New practices often do not have the staff training and systems to detect errors prior to submission.
Most common causes of denials are:
- Incorrect patient data: Address, DOB, or insurance ID discrepancies
- Authorization not received: Overlooked pre-certifications, particularly for behavioral health
- Coding discrepancies: Inaccurate CPT/ICD pairings or absent modifiers
- Late submission: Claims received beyond payer-specific timelines
- Medical necessity concerns: Lack of adequate documentation to justify the billed service
Even a few denials can drastically affect cash flow for a practice with only 20 patients weekly.
Choosing and Integrating the Right EHR & Practice Management Software
New clinics put extra stress on establishing electronic systems. Too many software providers sell to mid-sized clinics or large groups of enterprises, not individual practitioners. The wrong system can cause more issues than they solve.
Some of the usual issues new practices encounter are:
- Lack of claims integration with clearinghouses
- Poor training on charge entry and code linking
- Overbuilt features that don’t match a small clinic’s needs
Without proper billing integration, even good documentation can fail to produce accurate claims.
Hiring an In-House Biller vs. Outsourcing: A Straight Cost Comparison
Hiring even one certified biller involves substantial cost:
- Annual salary and benefits: $83,523
- Software and license fees: $10,000–$15,000 annually
- Training and compliance costs: Ongoing, often $5,000+/year
For new clinics running lean, this level of overhead isn’t realistic. Many solo physicians and small group practices find that outsourcing to a specialized billing firm is both financially practical and operationally safer.
How Scionis RCM Supports Startup Clinics
Scionis RCM works directly with new practices, small offices, solo MDs, and behavioral health providers, to prevent early revenue loss and establish a sustainable billing process. Here’s how:
1. Credentialing Management
We oversee the entire credentialing process, from application submission to payer follow-up. Our team tracks timelines and documentation requirements, reducing the risk of stalled claims.
2. Specialty-Specific Coding & Claim Submission
Whether your clinic is focused on family medicine or psychiatry, our certified coders apply specialty-specific CPT, ICD-10, and modifier protocols. We scrub all claims before submission to eliminate preventable errors.
3. Denial Prevention and Appeals
We audit denials weekly, identify root causes, and correct underlying issues. Our appeal process is backed by documentation standards and payer policy research.
4. EHR & PMS Consultation
We help you choose the right electronic system for your clinic size and workflow. Our team ensures your chosen EHR integrates cleanly with our billing platform, so claims flow without manual re-entry.
5. Real-Time Reporting & Support
You receive monthly performance reports and full transparency into collections, denial rates, and claim status. No blackout periods, no hidden metrics.
Real Cost Comparison: Scionis vs. Other Options
Cost Component |
In-House Billing |
Typical Billing Vendor |
Scionis RCM |
|---|---|---|---|
Focus on Medicine, Not Payer Red Tape
Launching your own practice should be about building patient relationships and clinical excellence, not chasing unpaid claims. Scionis RCM supports physicians in their first year of practice with billing solutions that prevent financial strain. Our model is built for lean startups that want accuracy, compliance, and peace of mind without overhead.
Ready to Launch With the Right Billing Partner?
If you’re a physician, psychiatrist, or nurse practitioner preparing to open a clinic, don’t leave billing to chance. Contact Scionis RCM to learn how our credentialing, claim submission, denial recovery, and EHR integration services can support your growth from day one.