How to Start Your Group Practice in 10 Steps

By Maureen Werrbach, LCPC on July 25, 2018
How to Start Your Group Practice in 10 Steps - TherapyNotes with Maureen Werrbach, LCPC

Setting up a group practice can feel overwhelming.

Since most of us don’t come from a business background, many make this transition in the dark. As new and established group practice owners have realized, there’s no manual or template that outlines best practices when it comes to starting a group practice. That’s because group practices vary so much in their setup and trajectory that there isn’t a one-size-fits-all solution. But there are some basic first steps that every group practice owner needs to take, and some common themes to consider.

Here are 10 important steps to take when getting your group practice off the ground.


1.) Write your business plan

This is by far the most skipped step by startups. What most group practice owners don’t think about is that the ideas that float around in our heads as new business owners are not enough to help us formulate any meaningful business plan. A solid business plan helps you form your thoughts into actionable steps and a path for your business. From organizational structuring and marketing analysis to management and finances, it covers a lot of what makes a group practice become successful. Read this guide on how to write a business plan to get started.


2.) Get legal

Set your business up as a legal entity. If you were set up as a solo practice legally, confirm with a business attorney that this setup works for a group practice. There are a handful of business structures for businesses, and it’s important that you set yourself up correctly now so you don’t have to change later. Trust me: It’s painful to make that transition later. To learn more, check out the LLC vs. S corporations blog and the IRS website.


3.) Find an employment attorney

It’s important to iron out the details of whether you’ll hire employees or independent contractors. We are not equipped to make this decision without the help of an employment attorney. There are legal ramifications to misclassifying them, and it’s a mistake that can be avoided by taking the time to discuss it with an employment attorney. Have them also put together contracts or offer letters, as well as operations and employee manuals.


4.) Figure out who you want to hire

Too often, new group practice owners hire friends, people they like, or people that have only some of the qualities or requirements they’re looking for because they’re eager to get started. Sit down and outline who your ideal clinician is, just as you know who your ideal clients are as a therapist. For more help in understanding who your ideal clinicians are, fill out this ideal clinician worksheet.


5.) Put together a recruiting, interviewing, hiring, and onboarding strategy

This is a great time to hire a coach to help you through this. Just as in point 4 above, many new group practice owners fly by the seat of their pants with this step. Having a solid process for finding, interviewing, and onboarding clinicians makes this process go seamlessly and encourages you to hire the best-fitting therapists. Check out this blog for hiring and onboarding therapists.


6.) Make a decision about insurance and start the process

Now it’s time to get a group practice NPI-2, update your CAQH, and decide if your group practice will be taking insurance. Does your group practice want group contracts with insurance companies? If so, you’ll need to check each individual insurance company, as they all have their own rules and requirements on having group contracts. You’ll also want to check with each individual insurance if you want to have some clinicians in network and some clinicians out of network, as it tends to create reimbursement issues. Here’s a step-by-step guide on getting paneled.


7.) Update your paperwork and website

A clean and easy-to-navigate website is essential for group practices. You’ll want to make sure that your website highlights your different therapists and makes it easy for a potential client to know who’s the best fit for them. You’ll also want to change the wording from “I, me, my” to “us, we, our” on your website and paperwork to signify group status. And it’s a great time to make sure all your paperwork reflects being in a group practice, including intake documents, release of information, credit card forms, consent to treatment, HIPAA documents, and any other forms you use in your practice.


8.) Come up with a marketing strategy

Marketing as a solo practice owner is completely different than marketing a group of individuals and a group practice. A group practice is a brand, and you want to have a marketing strategy that promotes your group practice brand as well as the individual clinicians in that group. One of the main concerns group practice owners have is that when they market their clinicians, people tend to refer to the group practice owner instead. A good marketing strategy takes this into account (among other things). Here are some tips on how to market your group practice and clinicians.


9.) Get your accounting set up

One of the things that gets put on the backburner is finding a quality accountant. As a way to save on operating expenses, many new group owners will try to do bookkeeping themselves and hire an accountant to do end-of-year taxes. This creates problems because most group practice owners become so busy, they stop doing the bookkeeping in real time, and estimated taxes end up being underestimated. A quality accountant will do your bookkeeping for you and keep your books accurate monthly. They’ll also track your income and adjust your quarterly estimated taxes so you don’t fall behind.


10.) Learn about HIPAA

Not that HIPAA isn’t important for solo practitioners, but there is a lot more to consider when you own a group practice and have a handful (or more!) of clinicians who are using technology like computers, email, fax machines, text messaging, and phones. It’s important that you feel confident in how your group practice handles HIPAA security. Take a HIPAA course and make sure your clinicians do as well.

Also, if you managed to be a paper-and-pen practice up until now, it's time to start using an EHR. As a group practice, nothing brings out disorganization more than not having systems in place. I use TherapyNotes™ to organize my group practice, and it’s been a lifesaver.

As you get started on this list, plan to check off one thing at a time. Once you do, you’ll be a lot closer to feeling confident as a new group practice owner.

* The content of this post is intended to serve as general advice and information. It is not to be taken as legal advice and may not account for all rules and regulations in every jurisdiction. For legal advice, please contact an attorney.


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