30-60-90 day plan for medical practice managers
On this page
- What makes a practice manager's first 90 days different?
- Which enrollment and compliance rules does a new practice manager check first?
- What does the 30-60-90 day plan look like?
- Which numbers should a new practice manager baseline?
- How should the owners use the plan in the final interview?
- What should each check-in cover?
- A filled example
- What do the owners owe the new practice manager?
- Common mistakes
- How do you adapt the plan?
- Questions people ask
A 30-60-90 day plan for a new medical practice manager should spend the first month on the things that stop a practice from being paid: every provider's license, payer enrollment and Medicare revalidation status, OIG exclusion checks for every employee, and a revenue cycle baseline. The second month fixes the largest denial and enrollment gaps and sets a monthly financial report for the physician owners, and the third delivers a budget and an operating plan the owners agree with. Federal rules below are as they read in October 2026.
This plan is for the physician owners, managing partner or administrator hiring a practice manager for an independent or physician-owned group. The site-level work (schedule templates, front desk, HIPAA, OSHA and CLIA records) is covered in the 30-60-90 day plan for clinic managers; this page adds what the owners hold the practice manager to. The general structure is in the 30-60-90 day plan template for new hires.
What makes a practice manager's first 90 days different?
A practice manager in a physician-owned group works for several bosses who are also the practice's main producers. Each owner has a view of what is wrong, usually about collections, staffing or their own schedule, and the views do not always agree. A new manager who starts by fixing one physician's complaint becomes that physician's manager. One who starts with data the whole group can see, on enrollment, cash and costs, becomes the practice's manager.
The second difference is that the most expensive problems are often invisible from the front desk: a provider whose enrollment lapsed, a new hire nobody checked against the exclusion list, a payer contract with a fee schedule that was never loaded. These are first-month work.
Which enrollment and compliance rules does a new practice manager check first?
Current as of October 2026; not legal advice. State licensing, payer contracts and state privacy laws add requirements. HIPAA, OSHA and CLIA records are in the clinic manager plan.
| Area | What applies | Source |
|---|---|---|
| Medicare revalidation | Enrollment information resubmitted and recertified every 5 years; CMS contacts the provider when it is due | 42 CFR 424.515 |
| Reporting enrollment changes | Change of ownership, adverse legal action or a change, addition or deletion of a practice location within 30 days; all other changes within 90 days | 42 CFR 424.516(d) |
| Exclusion screening | Excluded individuals and entities can receive no payment from federal health care programs; hiring someone on the LEIE can bring civil monetary penalties; OIG says to check the list routinely for new hires and current employees | OIG exclusions program |
| Good faith estimates | For uninsured or self-pay patients: within 1 business day of scheduling when the service is scheduled at least 3 business days ahead; within 3 business days when scheduled at least 10 business days ahead; within 3 business days of a request | 45 CFR 149.610 |
| Compliance program | OIG's voluntary guidance on the elements of a compliance program, including written policies, a compliance officer, training, auditing and response | OIG General Compliance Program Guidance |
| Medicare quality reporting | If the practice's clinicians are eligible for MIPS, someone must own the data submission for each performance year | CMS Quality Payment Program |
What does the 30-60-90 day plan look like?
30-60-90 day plan — [Name], Practice Manager, [practice]
Reports to: [managing partner / physician owners] Start date: [date]
Providers: [N] physicians, [N] NPs/PAs Sites: [N] Staff: [N]
Specialty: [ ] Billing: [in-house / billing company]
Main payers: [ ] Systems: [EHR / practice management]
DAYS 1-30 — Enrollment, exclusions and a financial baseline
Goals:
- Meet each owner one to one: what they want fixed, how partner pay
works, what decisions need a partner vote
- Enrollment list for every provider: license, DEA, board status,
Medicare enrollment and revalidation date, each commercial payer
- Check every employee and contractor against the OIG exclusion list;
set a monthly check
- Revenue cycle baseline from charge to cash (see below)
- Read every payer contract the practice holds; confirm fee schedules
are loaded in the billing system
- Spend a day with front desk, billing and each site lead
Deliverables by day 30:
- Enrollment and compliance gap list with owners and dates
- Revenue cycle baseline the owners agree with
Check-in: day 30, at a partners' meeting
DAYS 31-60 — Fix the leaks; start reporting
Goals:
- Close urgent enrollment gaps; hold scheduling for any provider not
yet approved by a payer
- Work the top three denial reasons at their source
- Set up good faith estimate workflow for self-pay patients if
missing
- First monthly report to the owners: visits, charges, collections,
A/R, denials, payroll as a share of collections, open issues
Deliverables by day 60:
- Monthly report delivered on a fixed date
- Denial fixes in place with a weekly count
Check-in: day 60
DAYS 61-90 — Budget and operating plan
Goals:
- Draft next year's budget with the accountant: staffing, rent,
supplies, systems, provider recruitment
- Map provider onboarding steps so a new NP, PA or physician can be
scheduled on day one
- Present a 12-month operating plan: payer mix, staffing, sites,
systems, compliance calendar
Deliverables by day 90:
- Budget approved or in final review; operating plan presented
- Compliance calendar: revalidations, licenses, training, MIPS
Check-in: day 90 — full review at a partners' meetingWhich numbers should a new practice manager baseline?
The standards below are examples only. Define each measure the same way every month, use the practice's own history and its billing system's reports, and show the trend.
| Measure | Why it matters | Example standard (example only) |
|---|---|---|
| Days in accounts receivable, and A/R over 90 days by payer | Where cash is stuck | Reported monthly by payer from day 60 |
| Denials by reason and payer | Most denials start before the visit | Top three reasons worked at the source |
| Charge lag (visit to claim) | Late charges delay cash and miss filing limits | Measured by provider; outliers discussed privately |
| Net collection rate | How much of what the practice is owed it actually collects | Calculated the same way each month with the accountant |
| Enrollment items open | Visits that cannot be billed | None unplanned by day 60 |
| Staff cost as a share of collections | The owners' most common cost question | Reported monthly with the staffing plan |
How should the owners use the plan in the final interview?
Give each finalist the same brief: number of providers and sites, specialty, billing setup, the owners' top concern and two pages of anonymized reports. Use the rubric in how to evaluate a 30-60-90 day plan in an interview. A strong plan puts enrollment, exclusions and the revenue cycle baseline ahead of new software or a reorganization. Scenario questions:
- "A new NP starts in two weeks and one major payer has not approved her. What do you tell the schedulers and the owners?"
- "You find a medical assistant hired last year who was never checked against the exclusion list. What do you do today?"
- "Two partners disagree about adding Saturday clinics. How do you bring it to a decision?"
- "Collections fell last month. What do you look at first?"
For hiring the billing team, the medical billing and coding screening questions test credentials, denial work and payer rules.
What should each check-in cover?
| Checkpoint | Questions to ask | On track | Worth a direct conversation |
|---|---|---|---|
| Day 30 | "Is every provider enrolled and every employee checked?" | Enrollment list complete with dates; exclusion check done; baseline agreed by all owners | Working one owner's complaint list; no enrollment list; numbers from the billing company accepted unchecked |
| Day 60 | "What did the first monthly report show?" | Report on a fixed date; denial fixes under way; no unplanned enrollment gaps | Report late or different each month; denials resubmitted without fixing the cause |
| Day 90 | "What is the plan for next year, and what does it cost?" | Budget in review; operating plan and compliance calendar presented | No budget; plans made without the accountant or the owners |
A filled example
Practice manager: Laura Kim (invented), previously a revenue cycle supervisor at a health system, joining a seven-physician, two-NP cardiology group with two offices and an outside billing company.
Day 30: Her enrollment list showed that one NP hired four months earlier was approved by Medicare but not by the second-largest commercial payer, and her visits for that payer had been billed under a physician. She stopped that immediately and raised it with the managing partner and the practice's attorney. The exclusion check found no matches; she set a monthly check.
Day 60: Her first monthly report showed that most denials were for missing prior authorizations on imaging. She moved authorization checks to the scheduling step and asked the billing company for denial data by reason every week.
Day 90: Imaging denials fell against her baseline. She presented a budget with the practice's accountant that funded a second authorization coordinator, and a compliance calendar with every provider's revalidation and license dates.
What do the owners owe the new practice manager?
- One voice for decisions: a managing partner or a clear partner-vote rule, so the manager is not negotiating with each owner separately.
- Access to the practice management system, payer portals, contracts, the billing company's reports and the general ledger.
- The practice's history: past audits, refunds, payer disputes and any compliance concerns.
- Spending authority and a named accountant and attorney the manager can call.
Common mistakes
- Trusting the billing company's summary. Ask for claim-level data and reconcile it to deposits before reporting to the owners.
- Scheduling providers before payer approval. The visits look like access gains and turn into write-offs or refunds.
- One-time exclusion checks. A check at hiring misses employees excluded later.
- Changing software in the first 90 days. A system change hides the baseline the owners need to judge the manager.
How do you adapt the plan?
- Hospital-owned practice: enrollment, billing and budget are often run centrally; weight the plan toward access, provider schedules and the site's compliance records.
- Practice adding advanced practice providers: pair this plan with the 30-60-90 day plan for physician assistants or the plan for nurse practitioners so enrollment and the clinical ramp match.
- Dental practice: the dental office manager plan covers hygiene recall and dental insurance.
- Manager seeking a credential: MGMA's credentialing arm, ACMPE, offers board certification for medical practice managers.
Questions people ask
What should a new medical practice manager do in the first 30 days?
Meet each physician owner, learn how decisions are made and how the partners are paid, then build three lists: every provider's licensing, payer enrollment and Medicare revalidation status; every employee and contractor checked against the OIG exclusion list; and a revenue cycle baseline from charge entry to payment. The clinic floor work (schedule, front desk, HIPAA and OSHA records) runs alongside but the owners judge a practice manager first on enrollment, cash and reporting they can trust.
How often do physicians have to revalidate their Medicare enrollment?
Under 42 CFR 424.515, as of October 2026, providers and suppliers other than DMEPOS suppliers must resubmit and recertify their enrollment information every five years, and CMS contacts them when it is time. Separately, under 424.516(d), physicians, nonphysician practitioners and their organizations must report a change of ownership, an adverse legal action or a change of practice location within 30 days, and other enrollment changes within 90 days. This is not legal advice.
Does a medical practice have to check the OIG exclusion list?
The OIG says excluded individuals and entities can receive no payment from federal health care programs, that anyone who hires an individual or entity on the List of Excluded Individuals and Entities may face civil monetary penalties, and that health care entities should routinely check the list for new hires and current employees, as of October 2026. Most practices check before hiring and monthly after that.
How is a practice manager different from a clinic manager?
The titles overlap, but in a physician-owned group the practice manager usually answers to the owners for the business as a whole: payer enrollment and contracts, the revenue cycle, the budget and financial reporting, compliance, and provider onboarding, often across several sites. A clinic manager more often runs one site's daily operations: the schedule, front desk, patient flow and the site's compliance records.