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Launch Checklist
Your 90-day countdown to your first patient — nothing left behind
90–120 day timeline
Credentialing takes 60–120 days per payer. Start 4–6 months before your target launch date. A 16-week revenue gap can cost $60,000+. Use Headway or Alma for income while you wait for direct credentialing to activate.
Months 4–6 Before Launch
Obtain your state RN + NP/APRN license
Get Type 1 NPI at nppes.cms.hhs.gov (free, 20 min)
Form LLC/PLLC with your state Secretary of State
Get EIN at irs.gov (free, instant)
Get Type 2 (organization) NPI using your EIN
Open business bank account + business credit card
Get malpractice insurance ($1M/$3M minimum)
Get DEA registration at dea.gov ($888 — required for prescribing)
Register with your state PDMP (often required within 30 days of DEA)
Set up QuickBooks Solopreneur
Month 3 Before Launch
Complete CAQH profile — all 18 sections
Attest CAQH and authorize all target payers
Apply for Medicare via PECOS ($750 enrollment fee)
Apply for your state Medicaid + all MCOs
Submit all commercial payer applications (Aetna, BCBS, UHC, Cigna, Humana)
Join Headway or Alma for early income while direct credentialing processes
Establish collaborative/supervision agreement if your state requires it
Build your referral network — PCPs, ERs, therapists in your area
Month 2 Before Launch
Follow up with every payer every 14 days by phone
Set up your EHR — SimplePractice, Jane, or TherapyNotes
Set up telehealth platform (built into EHR or separate)
Build your website with your accepted insurance list
Draft intake forms, consent forms, and office policies
Set up HIPAA-compliant secure messaging (OhMD, Spruce, or similar)
Set up e-prescribing through your EHR
Establish pharmacy relationships in your area
Launch Day & Beyond
See first patients under all approved plans
Track every dollar of income in QuickBooks weekly
Pay quarterly estimated taxes on time (Apr/Jun/Sep/Jan)
Set a 90-day CAQH re-attestation calendar reminder
Re-credential with additional payers as your volume grows
Review your Profit & Loss statement monthly
Join your state NP association for legislative updates
Schedule your DEA renewal 90 days before expiration
NP PRACTICEACADEMY
Verified from official state boards · Updated 2026