Guide
Opening Your Own Practice While You’re Still Employed: A 90 Day Plan
You can build your own practice while you're still at an FQHC, a group or a platform. This 90 day plan explains what to do first, what can run together and what waits on a payer. First Practice Launch covers the payer, EHR, scheduling and medical billing setup.
Practice Launch
You can do most of the setup while you’re still drawing a paycheck. Form the business, get the identifiers, build your CAQH/DataSpring profile and send first payer applications before you give notice. You can’t speed up the payer’s review, commonly 60 to 120 days in our experience, which is our own planning estimate, not a payer’s published figure. The plan is built around that wait, so your income keeps running until your contracts are effective.
Who This Plan Is For
This is for licensed clinicians (PMHNPs, therapists and LCSWs) at an FQHC, group practice or platform who want their own insurance contracts and practice before they leave. It’s a calendar: what to do first, what can run side by side, and what waits for a payer.
Undecided about opening a practice? Start with our guide to starting a behavioral health practice. Prescribers who want scope and prescribing details can use how to start a PMHNP private practice. If you hold contracts through Rula, Headway, Grow or Alma, what happens to your insurance contracts covers that side.
Days 1 To 14: Form The Business And Get An EIN
Your own contracts need your own business behind them. File with your state, usually through the Secretary of State or business registry, then get an Employer Identification Number from the IRS. Which kind of business to form is a legal and tax decision for a local attorney or tax professional. We guide the filing steps but never pick between an LLC and a PLLC for you, and we give no legal or tax advice.
The EIN is the easy part. The IRS issues it free, and if your online application is approved the number comes back right away. The IRS warns that some websites charge for it, and you never have to pay. Filing fees vary by state, and our cost breakdown for therapists shows three examples from the states’ own fee pages.
Days 7 To 21: The Type 2 NPI And Your NPPES Record
Every clinician has an individual NPI, a Type 1. Your practice needs its own organization NPI, a Type 2, issued by NPPES, the CMS system that assigns and stores NPIs. CMS says an incorporated individual can hold a Type 1 for themselves and a Type 2 for their corporation or LLC. Sole proprietors are Type 1 only.
Two things to know before you apply. An NPI is only an identifier. It doesn’t make anyone licensed or credentialed, and it doesn’t enroll you with a health plan. And changes to your records must be reported to NPPES within 30 days, so keep the practice address and taxonomy you enter here the same as everywhere else.
Days 14 To 30: CAQH/DataSpring And Your Practice Location
Payers pull credentialing data from CAQH/DataSpring, so get this profile right. It’s free to clinicians, you choose which plans get access, and you attest every 120 days, about three times a year. Our CAQH and DataSpring walkthrough covers setup and attestation.
Decide your practice location now and use it everywhere: the CAQH profile, NPPES, your W-9 and every payer application. Matching details are cheap to get right on day one.
Days 21 To 40: Pick The First Payers
Start with the payers whose members you expect to treat most, and ask each before applying whether it’s accepting new providers in your area and what it needs from you. Some want a tax ID, some a tax ID and an NPI. The payer’s answer governs.
You don’t have to apply everywhere at once. Start with a first round of commercial payers and add more later. Medicare runs through its own enrollment: CMS uses the CMS-855I for individual practitioners and the CMS-855B for an eligible group, while Medicaid enrollment goes through your state’s program. Add those as your caseload allows.
Applying While You’re Still Employed
The CMS fact sheet says individuals are only eligible for one NPI, so the number on your employer’s claims is the one you’ll use in your own practice.
The Medicare enrollment form for individuals expects that clinicians sometimes work with more than one organization. Its instructions say if you reassign benefits to more than one organization or group, copy and complete the page for each. Your practice’s payer contracts are separate applications under your new business’s tax ID and Type 2 NPI, and they can move forward while your current work continues.
Days 30 To 60: EHR And Clearinghouse Setup
Pick your EHR before the first approval arrives so you can load payer details the day a contract goes effective. A clearinghouse sends your claims to payers and returns their responses. Some EHRs include one and others connect to one, so ask how claims reach the payer and what it costs.
If the system allows, run a practice claim through your setup and confirm your practice address, Type 2 NPI and tax ID match your applications. For therapists comparing EHR costs, our therapy practice cost guide covers one published price. Prescribers can use what it costs to start a PMHNP practice.
EFT And ERA Enrollment
EFT is the electronic message a health plan uses to order its bank to send payment to your account. ERA is the plan’s explanation of how it paid and adjusted a claim. CMS encourages enrolling for both through each health plan you work with, so expect one enrollment per payer, not one for your whole practice.
Set up a business bank account first, since every payer will ask where to send money, then enroll payer by payer as each opens its portal. Your EHR or clearinghouse will tell you which ERA format it accepts.
Days 60 To 90 And Beyond: Follow Up And Keep Your Income Going
By day 60 your applications should be in and your systems ready. The last 30 days are for follow up: check with each payer on where your file stands, answer information requests the same day and keep a written record of every contact. We follow each payer at least every 10 business days on a client launch, and it’s a habit worth copying.
Ninety days gets you organized and submitted, not effective dates, and nobody can promise those. Payers commonly decide in 60 to 120 days in our experience, and it varies by payer. Keep your paycheck until at least one payer has given you an effective date in writing and your first claim under that contract has paid.
Frequently Asked Questions
Can I Apply For Insurance Contracts Before I Leave My Job?
Yes. Your business, Type 2 NPI, CAQH/DataSpring profile and payer applications don’t depend on leaving anywhere. Your individual NPI stays the same, and CMS’s Medicare form expects some clinicians to work with more than one group.
Do I Need A Type 2 NPI?
If your business will bill insurance, yes, it’s the business’s NPI. CMS says an incorporated individual can have a Type 1 for themselves and a Type 2 for their corporation or LLC. A sole proprietor uses only the Type 1.
Does Having An NPI Enroll Me With Insurers?
No. CMS states that an NPI doesn’t ensure a provider is licensed or credentialed, doesn’t mean a health plan will pay you and doesn’t enroll a provider in a health plan.
How Long Does Credentialing Take?
Commonly 60 to 120 days in our experience. That’s our planning estimate, not a payer’s published figure, and each payer sets its own pace.
Should I Choose An LLC Or A PLLC?
That’s a legal and tax decision, so we don’t make it for you. Talk to a local attorney or tax professional and check your state’s rules for licensed clinicians. We guide the filing and what follows.
Official Sources
If You’d Rather Not Run This Alone
First Practice Launch handles business and identifier coordination, credentialing and contracting with five commercial payers, payer portals with EFT and ERA enrollment, and EHR selection and setup. It’s $6,000, or $1,500 a month for four months, with five commercial payers included.
This is general information, not legal, tax or credentialing advice. Rules and forms change, so confirm current requirements with the agencies linked above. Last reviewed: November 6, 2026.
Need Help With This In Your Practice?
Use the guide yourself, or see the related service when you want AdvanceAPractice to handle the work.