Legal, Compliance & Credentialing

Services

Protect Your Practice. Get Paid. Stay Compliant.

A thriving medical practice isn’t just about providing great care—it’s about meeting complex legal, regulatory, and payer requirements. Without the right setup, you risk delayed reimbursements, denied claims, compliance penalties, or even the inability to operate.

At TruMediq Consulting, our Legal, Compliance & Credentialing service ensures your practice starts and operates on a rock-solid foundation—fully licensed, properly credentialed, insured, and compliant with every regulation that applies to your specialty.

We manage the process from start to finish so you can focus on patient care while we handle the paperwork, deadlines, and follow-up calls.

Overview

Why This Service Matters

Too often, practices fail to prioritize legal, compliance, and credentialing work—leading to:

  • Delayed start dates due to missing licensure or incomplete credentialing.
  • Lost revenue from denied or underpaid claims.
  • Risk of HIPAA violations and costly penalties.
  • Lapses in malpractice coverage leaving providers financially exposed.

With TruMediq Consulting, you get an expert, proactive partner who ensures these foundational steps are done correctly, on time, and with your long-term business health in mind.

We Offer

  • Medical Record Review & Legal Support – Detailed analysis of clinical documentation for malpractice.
  • Regulatory Compliance Audits – Ensure adherence to HIPAA, OSHA, and other healthcare regulations.
  • Expert Witness & Case Evaluation – Provide expert medical opinions, testimony, and case screening for legal proceedings.
  • Policy Development & Risk Mitigation – Draft and implement compliant policies to reduce legal and operational risks.

Our Full-Service Consulting Model Covers Every Stage of Your Practice

We start by analyzing your practice—or your vision for one—to create a clear, actionable plan for success.

  • Operational & Workflow Audits: Identify bottlenecks, inefficiencies, and opportunities for automation.
  • Expense, Vendor, & Contract Reviews: Negotiate with vendors and uncover cost-saving opportunities.
  • Revenue Cycle & Profitability Analysis: Pinpoint areas to improve collections and cash flow.
  • Strategic Growth Planning: Develop a step-by-step roadmap for expansion with projected ROI and timelines.

The right people, systems, and workflows are essential for a thriving practice.

  • Staffing Structure Reviews: Recommend efficient staffing models tailored to your patient volume and goals.
  • Hiring Support: Job descriptions, candidate screening, and onboarding systems to secure top talent.
  • SOP Creation: Clear, standardized procedures for consistency across your team.
  • EMR/EHR Setup, Training, & Optimization: Select, configure, and train staff for maximum system efficiency.
  • Patient Flow Redesign: Streamline every touchpoint from scheduling to checkout.

Revenue management and compliance are the backbone of your financial stability.

  • Insurance Credentialing & Payer Enrollment: Complete application management with Medicare, Medicaid, and commercial insurers.
  • Full-Service Billing & Claims Processing: Submit clean claims, post payments, and manage denials for maximum reimbursement.
  • Denial Management & Coding Compliance: Reduce future rejections with training and proactive audits.
  • HIPAA, OSHA, & State Compliance Reviews: Keep your practice audit-ready and risk-free.
  • Documentation & Charting Training: Improve chart accuracy and compliance while protecting against audits.

We help you attract, convert, and retain patients so your practice continues to grow.

  • Local SEO & Google Business Optimization: Ensure patients find you online easily.
  • Referral Network & Community Outreach Strategies: Strengthen relationships with referring providers and organizations.
  • Website Design, Enhancements, & SEO Upgrades: Build a mobile-friendly, patient-focused, search-optimized site.
  • Ongoing Marketing Campaigns: Drive patient acquisition with Google Ads, social media, and email campaigns.
  • Patient Engagement Tools: Automate appointment reminders, collect reviews, and send satisfaction surveys.

Our Comprehensive Staffing, SOPs & Operations Services

  • Identify your specialty focus, service offerings, and target patient population
  • Choose your model: insurance-based, Direct Primary Care (DPC), cash-based, hybrid, or telehealth
  • Develop your business plan, revenue projections, and growth strategy
  • Select and form your legal entity (LLC, PLLC, S-Corp, etc.)
  • Obtain your EIN, NPI (Type 1 & Type 2), and DEA registrations
  • Establish HIPAA compliance and review state-specific regulations
  • Create a detailed startup budget with fixed and variable costs
  • Provide funding strategy and connect you with lenders if needed
  • Build cash flow projections for the first 1–3 years
  • Analyze local demographics, patient density, and competitor landscape
  • Identify high-demand areas to maximize profitability
  • Negotiate leases and coordinate buildout with vetted vendors
  • Ensure ADA compliance, zoning approval, and space functionality
  • Select and configure your EMR/EHR and practice management systems
  • Develop SOPs for intake, scheduling, billing, and patient communication
  • Integrate telehealth platforms and secure messaging systems
  • Manage insurance credentialing and contracting for all providers
  • Maintain application tracking and provide regular updates
  • Strategically align payer mix with your financial goals
  • Create your practice name, logo, and brand identity
  • Build a professional, SEO-optimized website with online scheduling
  • Launch social media, referral partnerships, and local SEO campaigns
  • Plan your grand opening and patient outreach events
  • Develop staffing models and job descriptions
  • Recruit, interview, and onboard clinical and administrative staff
  • Create HR policies, employee handbooks, and payroll setup

• Implement HIPAA, OSHA, and OIG compliance protocols
• Provide staff compliance training with documented certifications
• Set up ongoing quality, safety, and risk management policies

  • Finalize pre-opening checklists and run mock workflows
  • Welcome your first patients and collect feedback
  • Monitor KPIs, adjust workflows, and plan for expansion

Our Comprehensive Staffing, SOPs & Operations Services

We connect you with the right talent for your specialty, culture, and patient volume—saving you time and reducing costly hiring mistakes.

  • Role Definition & Job Descriptions: Clear, detailed role outlines for front desk receptionists, medical assistants (MAs), registered nurses (RNs), and other essential positions.
  • Candidate Sourcing: Leveraging job boards, healthcare recruiting networks, and our own vetted talent pool.
  • Screening & Interviews: Conducting initial screenings, skills assessments, and culture-fit evaluations.
  • Onboarding Support: Preparing offer letters, new hire paperwork, and orientation plans to get staff productive from day one.
  • Retention Strategies: Advising on competitive pay structures, benefits, and professional development programs to keep turnover low.

We create clear, step-by-step SOPs that remove ambiguity, ensure compliance, and maintain consistency in patient care.
Front Desk SOPs:

  • Patient scheduling, rescheduling, and cancellations
  • Insurance verification and co-pay collection
  • Patient check-in/check-out protocols
  • Handling difficult patients and complaints

Intake SOPs:

  • Collecting accurate patient demographics and health history
  • Pre-visit screening and consent form procedures
  • Patient portal onboarding and usage instructions

Triage SOPs:

  • Prioritizing patient concerns and determining urgency
  • Routing messages and requests to the correct provider or department
  • Emergency response procedures within the clinic

Every SOP is tailored to your practice—aligned with your EMR system, patient flow, and compliance requirements.

A well-trained team is a confident, compliant, and patient-friendly team. We deliver targeted training to ensure every interaction meets the highest standards.

HIPAA Training:

  • Understanding patient privacy rules and PHI handling
  • Recognizing and preventing HIPAA violations
  • Secure communication practices for calls, emails, and EMR usage

Phone Etiquette Training:

  • Professional greetings and tone consistency
  • Effective call transfers and message-taking
  • Managing high call volumes without sacrificing quality

Patient Engagement Workflows:

  • Techniques for building rapport and trust with patients
  • Proactive appointment reminders and follow-ups
  • Strategies to increase patient satisfaction and retention

All training includes scripts, checklists, and role-playing exercises to ensure skills translate into daily practice.

Our Comprehensive Legal, Compliance & Credentialing Services

Before you can see your first patient—or bill for your first claim—you must have all essential licenses, identifiers, and compliance measures in place. We handle:

  • State Medical Licensure: Application or renewal for your provider license(s) in the states where you’ll practice, including telehealth-specific requirements.
  • National Provider Identifiers (NPIs):
    • Type 1 NPI – Individual provider identification.
    • Type 2 NPI – Organizational identifier for group practices.
  • DEA Registration: For providers prescribing controlled substances, we prepare and submit your DEA application, ensuring all state and federal requirements are met.
  • HIPAA Compliance Setup:
    • Written HIPAA policies and privacy practices tailored to your practice.
    • Business Associate Agreements (BAAs) with vendors.
    • HIPAA training for all staff with documented completion.

Implementation of secure communication protocols for patient data.

Credentialing is the process that allows you to get reimbursed by insurers—and it’s notoriously slow and complex if handled incorrectly. We:

  • Identify Your Payer Mix: Aligning your accepted insurers with your specialty, patient demographics, and financial goals.
  • Application Preparation & Submission: Completing initial credentialing packets for Medicare, Medicaid, and all selected commercial payers.
  • CAQH Profile Setup & Maintenance: Creating or updating your Council for Affordable Quality Healthcare (CAQH) profile to meet payer requirements.
  • NPPES & PECOS Updates: Ensuring your NPI and Medicare enrollment information are current.
  • Contract Negotiation & Review: Evaluating fee schedules and contract terms before you sign.
  • Follow-Up & Status Tracking: Persistent follow-up with payers to expedite approvals and resolve any application issues.

Re-Credentialing Management: Ongoing tracking of re-credentialing deadlines so you never lose active status.

Malpractice insurance protects your career, your assets, and your reputation. We help you:

  • Choose the Right Policy Type: Understanding the pros and cons of Occurrence vs. Claims-Made coverage.
  • Find Specialty-Specific Coverage: Matching you with carriers experienced in your field and risk profile.
  • Ensure Adequate Coverage Limits: Balancing cost with protection to safeguard against financial exposure.
  • Review Policy Terms: Identifying hidden exclusions, tail coverage requirements, and renewal conditions.
  • Connect You with Trusted Brokers: Leveraging our network to secure competitive rates and reliable service.

Accurate coding is the backbone of your revenue cycle and a major compliance requirement. Our team ensures your documentation supports your coding—and your coding supports timely reimbursement. We provide:

  • Specialty-Specific ICD-10 & CPT Code Libraries: Pre-built references for your most common procedures and diagnoses.
  • Provider & Staff Training: On correct code selection, modifiers, and documentation requirements to reduce denials.
  • Chart Auditing & Feedback: Reviewing sample charts for completeness and defensibility in case of payer audits.
  • Compliance-Driven Documentation: Ensuring medical necessity is clearly documented to meet payer and regulatory standards.

Ongoing Coding Support: Updates and refresher training as payer rules and coding guidelines change.

Our Approach

Why This Service Matters

Too often, practices fail to prioritize legal, compliance, and credentialing work—leading to:

  • Delayed start dates due to missing licensure or incomplete credentialing.
  • Lost revenue from denied or underpaid claims.
  • Risk of HIPAA violations and costly penalties.
  • Lapses in malpractice coverage leaving providers financially exposed.

With TruMediq Consulting, you get an expert, proactive partner who ensures these foundational steps are done correctly, on time, and with your long-term business health in mind.

The TruMediq Advantage

Healthcare-Specific Expertise

Trumediq online Medical Practice Consulting

We know the unique requirements for different specialties, states, and practice models.

End-to-End Management

Healthcare-Specific Expertise​

From applications to approvals, we handle it all.

Proactive Compliance

End-to-End Guidance​

Preventing problems before they impact your revenue or reputation.

Speed & Accuracy

Healthcare-Specific Expertise​

Expediting timelines with complete, error-free applications and constant follow-up.

Who We Help

Biopharma drug manufacturers

Provider groups

Wholesalers and distributors

Healthcare provider groups

Pharmacy - Retail and specialty pharmacy

Medical device and diagnostics

Digital therapeutics

Trade
organizations


Related Offerings /

Market Access
Analytics

Pricing Strategy

Patient Access and
Support Services

Commercial Launch
Readiness

Reimbursement
Assessment and Strategy

FDA and Regulatory Filing
Strategy

Case Studies and Testimonials

How We Have Helped Clients

Market Access

Product Utilization Data Analysis Informs Biotech Growth Strategy

A biotechnology company sought detailed product utilization data, by indication and line of therapy, and commercialization strategy support to help identify opportunities to improve access to its product. We leveraged our in-house claims data to assess the size and utilization patterns of the patient populations of interest, analyzing Part B claims data and translating analytic findings into actionable commercialization strategies (e.g., prioritization of target accounts based on factors such as patient volume, ownership affiliations, and changes in product market share). We developed visuals to convey the results of our analysis, which the client is using to better understand utilization trends and inform its growth strategy.

Market Access

Forecasting Global Value Assessments for Rare-Disease Drug Launch

Offering an integrated suite of healthcare consulting and global policy, access, and value capabilities, we helped an emerging biotechnology company develop a multi-national pricing and commercialization strategy for a drug to treat an ultra-rare neurodegenerative disorder. The client sought our expertise in determining how payers in priority markets would assess the product’s value given clinical trial data (e.g., endpoints and patient groups), product characteristics, and market dynamics in each country of interest (i.e., US, EU, UK, Canada, Australia, and Japan). We reviewed published literature on the indication, conducted a coverage and reimbursement landscape analysis for each of the client’s target markets, and convened advisory board meetings among US and global payers to strengthen the client’s pricing and commercialization strategy.

Market Access

Comprehensive Pre-Launch Planning for Competitive Novel Vaccine

We conducted primary and secondary market research, qualitative evidence assessments, quantitative conjoint analyses, and in-depth stakeholder interviews to help develop pricing and commercialization strategies for a novel vaccine preparing to launch against a competitor product.

Ready to Launch Fully Compliant and Credentialed?

Don’t let paperwork and payer processes slow you down. Let TruMediq Consulting handle the details so you can focus on patients.

Featured Experts

Featured Market Access and Commercialization Experts

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A One-Stop Approach

We’ve Done It Ourselves
We built TruMediq Mental Health from scratch and understand the realities of medical business ownership. We built TruMediq Mental Health from scratch and understand the realities of medical business ownership.We built TruMediq Mental Health from scratch and understand the realities of medical business ownership. We built TruMediq Mental Health from scratch and understand the realities of medical business ownership.
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Healthcare-Specific Expertise
We built TruMediq Mental Health from scratch and understand the realities of medical business ownership. We built TruMediq Mental Health from scratch and understand the realities of medical business ownership.We built TruMediq Mental Health from scratch and understand the realities of medical business ownership. We built TruMediq Mental Health from scratch and understand the realities of medical business ownership.
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End-to-End Guidance:
We built TruMediq Mental Health from scratch and understand the realities of medical business ownership. We built TruMediq Mental Health from scratch and understand the realities of medical business ownership.We built TruMediq Mental Health from scratch and understand the realities of medical business ownership. We built TruMediq Mental Health from scratch and understand the realities of medical business ownership.
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TruMediq Consulting Case Studies​

Launching a Future Psychiatrist’s Private Practice Before Graduation

In early 2024, a fourth-year psychiatry resident approached TruMediq Consulting with an ambitious vision: to have his own private ...

Nurse Practitioner Launches Profitable Private Practice with TruMediq Consulting

In early 2023, a nurse practitioner with five years of hospital experience decided to open her own private practice. Unsure of where ...

Simplifying Provider Workflow with a Custom Patient Queue System

In late 2023, a large multi-specialty healthcare organization recognized a growing problem: their existing provider queue assignment ...

Launching a Future Psychiatrist’s Private Practice Before Graduation
In early 2024, a fourth-year psychiatry resident approached TruMediq Consulting with an ambitious vision: to have his own private ...
Click Here
Nurse Practitioner Launches Profitable Private Practice with TruMediq Consulting
In early 2023, a nurse practitioner with five years of hospital experience decided to open her own private practice. Unsure of where ...
Click Here
Simplifying Provider Workflow with a Custom Patient Queue System
In late 2023, a large multi-specialty healthcare organization recognized a growing problem: their existing provider queue assignment ...
Click Here

Featured Insights

Read Our Take on Top Trends

FAQs for TruMediq Consulting​

What types of providers do you work with?

We work with physicians, nurse practitioners, physician assistants, mental health providers, and other licensed clinicians across specialties—whether starting a solo practice, group clinic, or telehealth operation.

Can TruMediq Consulting help me start a private practice from scratch?

Yes! We offer complete end-to-end services including business formation, credentialing, EMR setup, billing, staffing, and marketing—so you can launch your practice with confidence and support from day one.

I’ve never run a business before—can you still help me?

Absolutely. Many of our clients are first-time business owners. We simplify every step, handle all the backend logistics, and teach you how to manage your practice like a pro.

Will you help me form my LLC or PLLC?

Yes. We assist with entity selection, registration, EIN setup, and help you establish your legal and tax infrastructure properly.

Do you help with getting licensed and registered?

Yes. We handle NPI (Type 1 & Type 2), DEA registration, medical license guidance, and HIPAA compliance setup.

Do you help with insurance credentialing?

Yes. We credential providers with Medicare, Medicaid, and major commercial payers. We also manage CAQH profiles and follow up on enrollments.

How long does credentialing take?

On average, 60–120 days depending on the payer. We start the process early to avoid launch delays.

What EMR systems do you support?

We support We support all EMR systems including practice Athena, AdvancedMD, Charm, and others, and will help you guide on what is best for your practice. We help you select, configure, and train your team on your preferred platform.

Do you help with billing and claims processing?

 Yes. We set up your billing systems, train on CPT/ICD coding, integrate clearinghouses, and manage revenue cycle setup.

Can you manage my billing long-term?

Yes, we can manage your billing and claims processing long-term, with our skilled billing specialists.

Do you offer accounting services?

Yes. We help set up your accounting system (QuickBooks, etc.), categorize expenses, manage bookkeeping, and create financial reports. Our licensed CPA accountants deliver advanced tax strategies and personalized advisory services designed to maximize savings and support long-term financial growth.

Can you help with patient payment plans or financing?

Yes. We integrate platforms like Cherry, Sunbit, or CareCredit for patient financing and payment tracking.

Do you help with hiring staff?

Yes. We create job descriptions, provide recruiting strategies, assist with screening, and help train new hires on systems and workflows.

Can you help create my office procedures and protocols?

Absolutely. We develop SOPs for front desk, triage, intake, emergencies, and more—tailored to your practice model.

Do you build websites and help with branding?

Yes. We create SEO-optimized websites, logos, and branding packages with online scheduling and patient forms built in.

How will you help me attract patients?

We implement local SEO strategies, set up Google Business Profiles, manage online listings, and can run paid ads through Google and social media.

What happens after my practice is launched?

We offer ongoing support with KPI dashboards, workflow audits, growth strategies, and system optimizations to ensure long-term success.

Can you help me expand to a second location or telehealth?

Yes. We provide expansion planning, staffing forecasts, infrastructure setup, and marketing support for new sites or telehealth rollouts.

Do you help with exit planning or selling a practice?

Yes. We assist with practice valuation, preparation for sale, and guidance through partner buy-ins or external acquisition.

How long does the full setup process take?

Most clients go live within 8–12 weeks, depending on complexity. We move quickly while ensuring nothing is overlooked.

How involved do I need to be in the process?

We do the heavy lifting, but your input is key. We offer weekly check-ins, ClickUp task boards, Slack/email support, and a secure client portal to keep you informed and involved.

Do you offer payment plans?

Yes. We offer flexible payment options for eligible providers. Reach out to our team to discuss your situation.

Design of cornerstonehealth

Your staff is the face of your practice, and your operational systems are its backbone. The right people in the right roles—supported by clear, consistent processes—can mean the difference between a thriving, patient-centered clinic and a disorganized, stressful work environment.

At TruMediq Consulting, we help you recruit, train, and empower your team while building Standard Operating Procedures (SOPs) that keep your operations efficient, compliant, and patient-focused. Whether you’re launching a new practice or looking to improve an existing one, we’ll ensure your people, processes, and workflows work together seamlessly.

Why This Service Matters

A practice with skilled staff and clear processes:

  • Runs efficiently with fewer errors and bottlenecks
  • Delivers a consistent, high-quality patient experience
  • Operates in compliance with state, federal, and payer regulations
  • Frees up providers to focus on care instead of micromanaging operations

Poor staffing or lack of SOPs, on the other hand, can lead to:

  • High turnover and costly rehiring
  • Inconsistent patient experiences
  • Compliance violations and financial penalties
  • Lower provider productivity and morale