Independent practice
Operating framework for an independent medical office
Use this framework to decide which clinical services and business functions the practice controls directly, which work it contracts out, and how owners review performance.
DINOMO — Democratized Independent Network of Medical Offices is Ignite Health Partnership’s network for independently owned medical offices. Each office decides whether to use the physician directory, credentialing, payer-contract, revenue-cycle, or MEDFlow services. The office retains its own clinical and business decisions.
Section 01
Clinical services and capacity
Choose service lines from patient need, physician scope, staffing requirements, payment terms, and expected volume. Record who owns each clinical decision and who may change the workflow.
- List the visits, procedures, tests, and care programs the office can deliver safely.
- Document staffing ratios, call schedules, equipment, referral requirements, and clinical coverage.
- Review RVUs, direct-care fees, payer rates, supply costs, and denied claims before adding a service.
- Keep credentialing files, clinical policies, and service-line financial reports available for owner review.
Section 02
Contracts and revenue cycle
The owners should know which entity signs payer contracts, submits claims, receives payments, works denials, and controls billing records. Contracts should identify service levels, data access, termination rights, and transition duties.
- Track credentialing submissions and payer effective dates by clinician and location.
- Reconcile charges, payments, adjustments, refunds, and denials to the source record.
- Review underpayments and contract exceptions against the signed payer terms.
- Retain an export of patient, billing, and contract records in the formats required for a vendor transition.
Section 03
Practice reporting and decisions
Use records that the owners can inspect. Reports should connect staffing and service decisions to patient demand, collections, denials, costs, and available cash.
- Assign approval limits for hiring, purchasing, borrowing, and contract changes.
- Review patient access, schedule use, referral completion, claim status, and cash position on a fixed cadence.
- Record material decisions, supporting data, responsible owners, and follow-up dates.
- Stop or revise work that misses the clinical, legal, or financial requirements set by the practice.