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Out-of-Network Practice Strategy & Launch

$0.00

Complete 90-Day Startup Architecture for High-Performance OON Practices

Target Audience:
Physicians establishing a new out-of-network practice or transitioning their existing practice from in-network to OON.

Overview:
Launching an out-of-network practice requires precision, compliance infrastructure, airtight financial protocols, and disciplined operational design. Ark Advisory Group delivers a complete 90-day OON practice build, covering clinical workflows, entity structuring, payer-safe separation strategies, staff readiness, billing operations, NSA compliance, and the full revenue cycle.

This is a turnkey launch solution that handles the technical, regulatory, and operational heavy lifting—so you can open your doors and generate high-value reimbursements from day one.

Complete 90-Day Startup Architecture for High-Performance OON Practices

Target Audience:
Physicians establishing a new out-of-network practice or transitioning their existing practice from in-network to OON.

Overview:
Launching an out-of-network practice requires precision, compliance infrastructure, airtight financial protocols, and disciplined operational design. Ark Advisory Group delivers a complete 90-day OON practice build, covering clinical workflows, entity structuring, payer-safe separation strategies, staff readiness, billing operations, NSA compliance, and the full revenue cycle.

This is a turnkey launch solution that handles the technical, regulatory, and operational heavy lifting—so you can open your doors and generate high-value reimbursements from day one.

What’s Included (Deliverables)

1. Entity Structure & Regulatory Compliance Setup

  • Guidance on entity separation for in-network vs. OON operations

  • Ownership structure review (state-specific corporate practice laws)

  • Compliance check for federal/state OON requirements

  • NSA/IDR compliance architecture

  • Good Faith Estimate templates and workflows

  • Financial liability disclosure packets for patients

2. Financial & Reimbursement Strategy

  • OON fee schedule design (UCR data, competitive benchmarks)

  • High-value CPT mapping for specialty services

  • Upfront collections and financial counseling workflows

  • Superbills, pre-payment structures, and member packages

  • Comparative revenue modeling vs. Medicare and commercial rates

3. Operational Infrastructure Build

  • Full practice operations roadmap (front desk → billing → appeals)

  • EMR/PM setup guidance and workflow design (ECW, Charm, Athena, or preferred system)

  • Staff role definitions, SOPs, and onboarding checklists

  • Scheduling templates for OON visit types

  • Call center and patient communication scripts

4. Billing & Revenue Cycle Setup

  • Clean claims and charge capture design

  • Authorization requirements matrix

  • Coding integrity review and OON-specific modifiers

  • WC/PIP/IDR appeal workflows (if applicable)

  • AR management and 90-day playbook

  • Reporting dashboards (NCR, AR aging, denial rate, cash acceleration)

5. Marketing & Growth Foundation

  • Website & branding review (or creation support)

  • Affluent-patient targeting strategy (40–55 demographic focus)

  • Digital presence setup and online reputation guidance

  • Optional: concierge membership design add-on

Timeline

A structured 12-week execution cadence:

  • Weeks 1–2: Entity structure, compliance, financial strategy

  • Weeks 3–6: Operational workflow build, staff alignment

  • Weeks 7–10: Revenue cycle implementation & QA

  • Weeks 11–12: Pre-launch readiness, final testing, go-live