State Medical Licensing
Every physician needs a medical license in the state where they practice. Processing times range from 4 weeks (Texas) to 6+ months (California). Apply early — delays here push back your entire launch timeline.
What you need:
- DEA registration
- ECFMG certification (international medical graduates only)
- USMLE transcripts
- Medical school diploma
- Residency completion letter
- Malpractice history (complete, even if zero claims)
Insurance Credentialing (if you accept insurance)
CAQH is the universal credentialing database used by all major payers. Even if you plan to practice direct-pay only, keep your CAQH profile active — hybrid arrangements are common, and it takes months to reactivate.
Steps to credential with payers:
- 1Register at proview.caqh.org and create your provider profile
- 2Complete all sections — gaps delay payer applications by weeks
- 3Re-attest every 120 days (CAQH will email you reminders)
- 4Apply to each payer individually using your CAQH ID
Direct-pay / independent practices can skip most insurance credentialing — but keep CAQH active for hybrid practices or if you ever want to accept Medicare or Medicaid for specific services.
Malpractice Coverage
Understanding your policy type matters before you sign anything. The wrong choice when leaving a job can cost you tens of thousands in tail coverage.
Occurrence Policy
Covers incidents that happen during the policy period regardless of when the claim is filed. More expensive per year, but no tail coverage needed when you leave.
No tail neededClaims-Made + Tail
Covers claims filed during the policy period only. You must purchase tail coverage when leaving a job or your prior patients are unprotected. Cheaper upfront, expensive on exit.
Tail required on exitMost independent practices qualify for lower premiums due to reduced procedure complexity and scope. CRICO, Coverys, and NORCAL are commonly used by independent physicians and offer competitive rates for direct-pay settings.
Legal Documents (Download Free)
These templates are starting points — have a healthcare attorney in your state review before using. Laws vary by state and practice type.
DPC Membership Agreement Template
A plain-English direct-pay membership contract you can adapt to your practice. Covers fees, services, termination, and limitations of scope.
Download PDFHIPAA Notice of Privacy Practices
Required for every practice. This template covers the minimum required disclosures for a direct-pay primary care setting.
View TemplateBusiness Associate Agreement (BAA) Template
Required when sharing PHI with vendors (labs, EMRs, scheduling tools). Covers the major HIPAA BAA provisions.
Download PDFType 2 NPI Registration Guide
Step-by-step instructions for registering an organizational NPI for your practice entity — required before billing any payer.
Download PDFThe Lean Practice Tech Stack
You don't need enterprise software. A solo or small independent practice can run cleanly on less than $200/month in tools before factoring in MEDFlow.
What the $40,000 consultant charges for — and what Ignite replaces
Practice setup consultants provide real value — but most of what they do is now automatable, searchable, or freely available.