Comprehensive Checklist of How to Start a Medical Practice in Texas

If you’re looking to start a medical practice in Texas, you may be wondering “How the heck do I do this on my own?” or “Where do I start?”

We provide this exact guidance for clients every day. Like any major project, the key is to divide and conquer. 

Here’s our working checklist for starting a medical practice in Texas, in no particular order of importance.

How to Start a Medical Practice in Texas

1.  Administration & Preparation

Starting a medical practice in Texas means a lot of behind-the-scenes administrative decisions. With this in mind, it helps to learn about running a clinic efficiently and team-based medical care, before you get into it. 

1. 1. Determine the business model and tax structure
   2. Establish a company agreement
   3. Develop policies & procedures
   4. Obtain a Group National Provider Identifier (NPI)
   5. Obtain Tax/Employer Identification Number (EIN)
   6. Register with Texas Health Maintenance Organizations/PPOs and Government Payers

2.  Office & facilities

While thinking about the physical location of your practice and the certificates you need to open, it is a good idea to be aware of potential challenges you may face.

1. Medical practice location selection
2. Office lease
3. Real estate lawyer
4. Furnishings
   - Reception
   - Exam Rooms
   - Back Office
5. Certificate of occupancy
   - Fire inspection
   - Safety inspection
   - City inspections
6. Signage
7. Optional: landscaping
8. Optional: interior decorator

3.  Equipment & Supplies

1. Filing cabinets and storage
2. Exam room equipment & supplies
3. Petty cash box and book

4.  Vendors & Suppliers

Many partnerships help you run your practice effectively. 

1. 1. Contracts for lab, x-ray, MRI, or other if needed
   2. Medical waste management and disposal if necessary
   3. Document destruction
   4. Janitorial & maintenance
   5. Practice management services and/or medical billing and credentialing service
   6. Accounting firm
   7. Law firm
   8. HR management
   9. Staffing firm
   10. Marketing services
   11. Collection agency

5.  Technology

1. Internet access
2. Wi-Fi
   - Guest Wi-Fi for patients
   - Main Wi-Fi for personnel
3. Copier with scanning
4. Dictating equipment if necessary
5. Phone system
6. Answering service
7. Cell phones w/ HIPAA compliance
8. Intercom
9. Fax machine
10. Medical office computer system
    - Hardware
    - Software
    - Connectivity
    - EHR
    - Digital forms
    - Patient portal
11. Practice management system

6.  Financial & Billing

1. There are ways to get medical practice funding in Texas. Also, it is a good idea to look into the use of healthcare AI to streamline office workflow. 

   1. Determine setup costs & expenses
   2. Calculate overhead
   3. Develop a standard document for loan and cash flow projections
   4. Billing software vs. outsourced services
   5. Establish patient financial policy
   6. Banking
      - Financing
      - Set up a business checking account
      - Merchant services/ credit card processing
      - Deposit stamp for checks
      - Electronic draft transfer
   7. Establish fee schedule
   8. CMS 1500 claim forms
      

       

      7.  Coding & Documentation

1. CPT, ICD-10, HCPCS coding books
2. Forms
   - Prescription forms
   - New patient registration
   - Patient medical history- Return to work/school
3. Charge ticket
4. Release of medical records
5. Progress of medication notice
6. Hospital rounds records

8.  Insurance

1. Visit the Texas Department of Insurance for applications and information
2. Malpractice insurance
3. Business insurance
4. Medical liability
5. Disability insurance
6. Health insurance
7. Life insurance
8. Employee fidelity bond
9. Umbrella policy
10.  Workers' compensation

9.  HR & Staffing

1. Now is the time to be conscious of the challenges Healthcare HR face currently and also begin thinking ahead to include employee appreciation for the staff you are about to hire. When it comes to medical practice startups, now is also the time to consider whether virtual assistants will be beneficial to your current needs. 

   1. Identify roles & job descriptions
   2. Choose personnel sourcing methods
   3. Review DFW medical office salaries data
   4. Personnel benefits plan
   5. Training for office personnel
      - Policies & procedures
      - HIPAA
      - OSHA
      - Stark
      - CLIA
      - Universal Protocol Training
      - Disaster response
   6. Personnel manual
   7. Payroll software/service
   8. Personnel management plan

10.  HIPAA

1. Learn about HIPAA Security Risk Assessments and data security as you work your way through this section of the checklist. 

   1. Create a guide to compliance & non-compliance
   2. List personnel rules & guidelines
   3. Outline violation response plan
   4. Designate a HIPAA privacy & compliance officer
   5. Perform security risk assessment
      - Overview of all protected health info (PHI) you create, receive, or transmit
      - List of all physical/digital locations where PHI is stored/maintained
      - Assessment of current security measures in practice
      - Rundown of possible threats and vulnerabilities to PHI
      - Evaluation of each threat’s likelihood
      - Determination of the impact of potential threats

11.  Business Development

Naming your practice and getting the ball rolling to get the word out are important aspects of developing your business.

1. Announce practice opening
   - To colleagues
   - In local newspaper/other local media
   - Open house for referring physicians
2. Join Chamber of Commerce & local business organizations
3. Apply to get put on DFW & TX physician directories
4. Website design, development, & maintenance
5. Create Brand 
   - Finalize business name
   - Create brand identity
   - Finalize logo design
   - Order branded practice materials
          - Brochure/pamphlets
          - Business cards
          - Announcements
          - Stationery
6. Create practice newsletter
7. Community outreach
8. Online Reputation Management (ORM)
9. Identify practice referral services
   - DFW medical societies
   - Hospital
   - HMO/PPO/IPA, ACO participation
   - Medicare participation/non-participation decision
10. Find contacts with social service agencies & others for referrals
11. Identify potential referring physician contacts
12. Apply for memberships as desired
    - DCMS and branch societies
    - County specialty society
    - Civic and church orgs
    - DCMSAF

Need advice on how to start a medical practice in Texas?

Now that you have a startup checklist, you can get things moving. If you need assistance, we can help you get set up, as well as assist with administration, billing, credentialing, human resources, and other practice operations - whether you are thinking of starting a new practice, adding a location, or looking for Physician Practice Management for your existing practice.