What changes when a physician leaves employment and becomes responsible for billing, payer contracts, and collections? Dr. Adil Ahmed and Dr. Humayun Naqvi explain the business systems that medical training often leaves out—from RVUs and facility fees to credentialing, insurance networks, benefits verification, prior authorization, and revenue cycle management.Drawing on Adil’s current move into solo practice and Humayun’s experience building an independent cardiology practice, they discuss why opening the doors can take months, how a group NPI differs from an individual NPI, why commercial payer contracts may arrive gradually, how IPAs can increase negotiating leverage, and where cash-pay or direct-care models fit. They also examine how physician ownership can affect operational control, resource use, and the patient experience.YOU’LL LEARN• How an employed RVU model differs from private-practice billing and collections• Why professional fees, facility fees, and ancillary revenue are distinct• What credentialing and contracting require before a new practice can bill payers• How IPAs, in-network contracts, out-of-network care, cash pay, and direct primary care differ• What revenue cycle management includes before and after a patient visit• Why benefits verification and prior authorization consume substantial staff and physician timeCHAPTERS00:00 Intro00:28 Why physicians want more career options03:13 Billing, credentialing, and RCM06:33 How RVU compensation works10:25 Private practice runs on contracts and collections12:57 Professional fees versus facility fees17:14 Ownership, efficiency, and aligned incentives20:56 Physician control and the patient experience23:36 What credentialing and contracting mean26:15 Group NPIs and Medicare enrollment30:49 IPAs and payer-contract negotiation35:40 In-network versus out-of-network care38:28 Cash pay, concierge care, and DPC39:52 RCM and benefits verification45:33 A cardiology prior-authorization case48:05 The restaurant analogy for third-party payment52:06 Encouraging physicians to take the leapThis conversation is for general educational purposes only and is not personal medical, legal, financial, insurance, or business advice. Rules, contracts, reimbursement, and credentialing requirements vary by payer, specialty, location, and practice structure.#PrivatePractice #MedicalBilling #RevenueCycleManagement #PhysicianLeadership
