Over the past 7 years, Pinnacle Practice Achievement has played an instrumental part in allowing physicians who are currently employed or right out of residency to take the leap and "Hang their own Shingle." No other consulting firm offers podiatry specific start up programs that encompass such a high level of detail and expertise at affordable prices.

At several points throughout the process of practice development, a much more intense level of involvement is required compared to working with existing practices. For this reason, Cindy and her physician advisors limit the number of start up clients who may be on a similar timeline in order to provide the one on one attention they need.

The dream of owning your own practice can become a reality. They did for these DPMs!

Startup Services to include:

Professional Services (Introducing/Securing):

  • Legal Counsel
  • Accountant
  • Architect/Interior Designer/General Contractor
  • Billing/Revenue Cycle Management Company
  • Credentialing Firm Compliance Services to include but not limited to
    • OSHA, HIPAA and Cyber Security


  • Drafting of 3-5 year financial projections to aid in:
    • Securing of Financial Backing
    • Creating Budgets
    • Introduction to investment planning and wealth/asset management for practice growth

Location/Space Planning

  • Introduction to Commercial Real-Estate Agent (based on):
    • Location Analysis (State, City and County)
    • Demographic Analysis
    • Spatial Needs and Considerations/Plan for Future Expansion
      • Office Layout/Best use of Space for flow and efficiency
  • Touring of commercial properties with representative RE Agent
  • Assistance with Negotiating of Commercial Property/Space (rent, lease or purchase) through RE Agent
  • Execution of lease or Securing of Mortgage
  • Commencement of Office Build out vs. Leasehold Improvements
  • Coordination of Move In


  • Entity Formation/Business Registration, etc.
  • Business Plan Development and Implementation
  • Protection of Assets


  • Malpractice Insurance/Broker
  • Business Related, Health and Disability Insurance


  • Obtaining of state license (and county where necessary)
  • Obtaining of Federal and State Narcotic Licenses
  • Credentialing for Insurers (including Durable Medical Equipment)
  • Applications for hospital and surgical center privileges
  • Discussion of Options for affiliation with hospital IPAs for improved fee schedules
  • Applications for Skilled Nursing Facilities and Outpatient facilities (if desired)


  • Assistance with:
    • Ad placement for staff
    • Interviewing tips and techniques
    • Personality testing and metrics
    • Hiring of Staff
    • Employee Handbook Development (see below)
    • Training Staff through
      • Online lessons and exams
      • Video Meetings and Training Sessions
    • Probationary Period Recommendations and Assessment Tools for Performance Reviews
    • Recommendations for hiring and training Physician/Practice Liaison


  • Finding/Securing Electronic Medical Record (Charting) and Practice Management (Billing, Claims Submission, Receivables) Software
    • Coordination of Staff and Physician Training to Optimize Charting and Claims Submission Efficiency and Minimize Claim Rejection Rates
  • Providing complete lists of medical/surgical supplies and equipment for initial stocking of office
  • Assistance with Initial Ordering/Purchasing of:
    • Office Furniture (selected to maximize efficiency and time)
    • Electronics and Ancillary Equipment (digital x-ray, etc.)
    • Office (Administrative) and Clinical Supplies


  • Creation of Office Policies and Procedures (Employee Manual/Handbook)
  • Development of Office Procedures and Treatment Specific Protocols
    • Protocol Menus provided for ease of development
    • Introductions to preferred vendors/service providers
  • Assistance with:
    • Development of Financial Policies and Collections Procedures
    • Coordination of Payroll Services
    • Finding/Securing of Merchant Services Vendor


  • Finding/Securing:
    • Web Developer
    • Development of Practice Logo
    • Suggestions for Branding through Print and Media through consistent Graphics and Practice Mission Statement
    • Building Practice Website
    • Design of Print Collateral/Marketing Materials to include:
      • Stationary, Business/Appointment Cards, Office Forms, Patient Condition and Treatment Educational Pieces, Practice
        brochure, Patient Give a Ways and Promotional Items
    • Commencement of Marketing to potential patient and referral base
      • Suggestions for “Shoe Leather Marketing” within your community
    • Commencement of Online Marketing/Social Media Presence
      • Blogging Services with highest unique content for Search Engine Optimization (SEO)
      • Claiming and Optimizing all directory listings to increase organic search results
      • Staying connected with your patients through email/drip campaigns and newsletters
    • Optimization of patient testimonials and online reviews
    • Monitoring and Analysis of Referral Sources
    • Tracking ROI of Marketing Efforts


Additional Explanation of Program Services and Special Notations:

  • A customized timeline will be provided based on practice “open date” goals.
  • Program includes bi-monthly conference calls to monitor progress during planning and development phase (more if required as grand opening date approaches) and for 60 days following practice commencement.
    • Please note: Fees do not include services and goods recommended by Pinnacle Practice Achievement (PPA)
  • Examples:
    • Online Marketing Services
    • Website Development
    • Electronic Health Record Software and Implementation
    • HIPAA Compliance Services
    • Supply and Equipment Purchases
    • Legal Counsel Fees for Employee Manual review.

Many of the recommended vendors and service providers will extend/offer preferred pricing due to your practice’s affiliation with Pinnacle Practice Achievement.

There are no formal requirements to utilize the products or services of any vendor or provider recommended by PPA, however, it is advisable. This allows our team to remain actively involved as imperative decisions are made and action item are accomplished (as they relate to the future success of your practice).

Consultation and Management Continuum

Following practice commencement and completion of active credentialing with all carriers (approximately 90 days into active practice), custom consulting programs are available and strongly recommended at a varying rates (depending on number of providers, staff members and locations) to include:

  • Bi-monthly conference calls to address concerns and areas in need of increased attention
  • Continued suggestions for Internal and External Marketing/Promotion of practice
  • Monthly video Staff Training sessions/meetings to review and reinforce details of office policies/systems and treatment specific protocols including:
    • Scripting of explanations and role-playing exercises to assure comprehension of products and services provided
    • Collections processes, handling of difficult patients/situations
    • Team (staff and physician) efforts as they relate to development of practice benchmarks/goals
    • Other specified areas in need of special attention
  • Continued access to online (password protected) lessons and quizzes (as new/additional employees are hired)
  • Monthly reporting (working with revenue cycle management vendor/biller) to include:
    • CPT analysis, DME and cash product dispensing, and patient visit value
      • These reports will serve to measure team performance, effective
        utilization of protocols and to identify areas of the practice that
        may require modification or additional attention in order to meet
        practice goals. Metric measurement is essential to practice growth.

The Pinnacle TEAM looks forward to helping your new practice achieve and exceed your expectations!

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