Adding a New Provider? Start Here.

Adding a provider to your practice usually means you're growing. But before you give them a start date and start putting patients on their schedule, there are several things you need to have in place.

Your provider needs to know what is expected of them, what they are responsible for, what the practice is responsible for, and who handles what.

That starts with a solid onboarding process.

Here’s what you need to have in place before your next provider starts.

Start with the logistics

Before you get into credentialing, EHR setup and everything else, get clear on how this relationship is actually going to work.

Answer these questions:

☐ Are they an employee or independent contractor?

☐ Do you have an agreement in place?

☐ How will they be paid?

☐ How often will they be paid?

☐ What happens with cancellations and no-shows?

☐ What schedule or caseload are you expecting them to maintain?

☐ What documentation expectations do you have?

☐ What administrative responsibilities belong to them?

These things should not be figured out after the provider starts.

Think through your onboarding process

What does this provider need to know to successfully work within your practice?

If you're using an EHR, are they already familiar with it?

If not, who is going to train them?

Even if they have used the same EHR before, they still need to understand how you use it in your practice. Create a workflow for them to follow, that clearly outlines what they are responsible for from patient scheduling/intake to claim submission and payment.

Think through:

☐ EHR and documentation

☐ Scheduling

☐ Billing processes

☐ Practice policies and procedures

☐ Communication expectations

☐ Clinical expectations

☐ Who they contact when they have a question or problem

Decide who is responsible for what

This is a big one.

Who handles:

☐ Credentialing and payer enrollment?

☐ EHR setup?

☐ Billing?

☐ Eligibility and benefits?

☐ Prior authorizations?

☐ Scheduling?

☐ Provider payment?

☐ Clinical supervision, if applicable?

☐ Administrative questions?

Someone needs to own each piece.

Know what you need from the provider

Don't start chasing documents after you've already started the credentialing process.

Have a standard list of what every new provider needs to give you.

This may include:

☐ Professional license

☐ Individual NPI

☐ CAQH information

☐ Malpractice insurance

☐ Education and work history

☐ Certifications or DEA information, when applicable

☐ Medicare or Medicaid enrollment information, when applicable

☐ Anything else required for payroll, HR or your internal systems

Give them the list upfront and give them a deadline.

Then think about credentialing

If you're an insurance-based practice, this needs to be part of your onboarding timeline from the beginning.

Which insurance payers will this provider be in network with?

Do they need Medicaid or Medicare enrollment?

Identify the timeline for credentialing.

Most importantly:

When can you actually bill for their services?

You need an effective date.

Make sure they're actually ready to bill

Before insured patients start hitting the schedule, make sure the administrative setup matches the credentialing.

☐ Provider is set up correctly in the EHR

☐ NPI and taxonomy are correct

☐ Billing and rendering information is correct

☐ Supervision or billing arrangements are established, if applicable

☐ Credentialing effective dates are documented

☐ Billing knows the effective dates

☐ Scheduling knows which insurance plans the provider can and cannot see yet

This is where provider onboarding becomes part of your revenue cycle.

Your onboarding checklist should answer three questions

What does the practice need to have in place?

What does the provider need to have in place?

Who is responsible for each piece?

Get those answers before the provider starts.