Ninety days does not produce a profitable billing service; it produces a complete, credible, operating business with a live pipeline. Date started:
Days 1–30: Build the Thing
☐ Runway number written down, with a stop date: $ through
☐ LLC formed, EIN obtained, bank account open
☐ E&O policy bound
☐ Attorney-reviewed service agreement and BAA templates bought
☐ Free software accounts live; mock practice built; claims entered and scrubbed
☐ Domain registered with a simple three-page site (what you do, who for, how to reach you)
☐ CPB scheduled and free CMS materials started daily, if you are the career-changer
☐ Fifty-practice list with office managers' names and trigger-event flags
☐ Five adjacent vendors identified: EHR consultant, medical accountant, chamber regular, others
Days 31–60: Work the Graph
☐ Warm asks made: everyone who knows a provider, one specific low-pressure ask
☐ Five vendor relationships, one coffee each
☐ One medical society or chamber event on the calendar
☐ Cold learning calls started in week six: ten a week, tracked, every objection logged
☐ Ninety-day claims review offer drafted, with the one-page report template behind it
☐ Three subcontracting proposals sent, if you are the apprenticeship type
Days 61–90: First Revenue-Shaped Activity
☐ One warm introduction become a conversation, or one subcontracting proposal become overflow work at a per-claim rate
☐ One diagnostic review closed at a modest flat fee
The Day-90 Decision (a decision, not a funeral)
☐ Extend with a niche change. Behavioral health instead of physical therapy. A different county. A sharper diagnostic offer. One variable, not all of them.
☐ Convert to apprenticeship mode. Ninety days landing subcontract work; return to client acquisition with references and runway rebuilt.
☐ Stop cleanly. Claim mechanics, Medicare rules, and compliance discipline are employable at practices and billing companies right now. The door reopens when the runway does.
Leading Indicators (measure the quarter in these, not dollars)
☐ Fifty-list contacts made:
☐ Warm asks made:
☐ Coffees held:
☐ Cold calls logged:
☐ Proposals or subcontract bids sent:
You control all five. You control none of the timing on the yes.