How to Start a Telehealth Practice: The Complete Step-by-Step Guide

Why This Guide Exists

Most healthcare professionals who want to launch a telehealth practice face the same problem: they have exceptional clinical training and almost no business education. They know how to deliver care. They don't know how to build the organization that delivers it.

This guide was built to close that gap. It covers major phases of launching a telehealth practice — from foundational business decisions and regulatory planning to technology, credentialing, and early patient-acquisition strategy.

This is the guide Dr. Charlene Haymond, DNP, APRN, FNP-C wishes she had when she launched First Priority Clinic, PLLC.

Step 1: Business Planning

Before you open a bank account, file paperwork, or purchase a single piece of technology, you need a business plan.

A telehealth business plan is not a formality — it is the strategic document that will guide every decision you make in the first 24 months of operation. It should cover:

Business Model How will you generate revenue? Direct-pay only? Insurance-based? Hybrid? Subscription? Concierge? Each model has distinct advantages, legal implications, and operational requirements.

Target Patient Population Who will you serve? A clearly defined patient population — by condition, demographic, geography, or clinical need — makes every subsequent decision easier and every marketing message more effective.

Service Offering What clinical services will you provide? What is out of scope? What ancillary services or digital products will supplement clinical revenue?

Financial Projections What are your startup costs? What is your revenue target at 6, 12, and 24 months? What is your break-even patient volume?

Step 2: Legal Structure and Business Formation

The legal structure of your practice has significant implications for liability, taxation, and operations. Common structures used by healthcare practices may include:

• PLLC (Professional Limited Liability Company) — available or required for certain licensed professionals in some states
• PC (Professional Corporation) — used or required in some states for certain professional practices
• S Corporation tax election — an option some eligible businesses consider with tax guidance

Work with a healthcare attorney and qualified tax professional to determine the appropriate structure for your state, specialty, and business model. Do not rely on generic online business formation services as a substitute for healthcare-specific legal guidance.

Step 3: Licensure and Regulatory Compliance

This is where many new telehealth entrepreneurs make their first major mistake — underestimating regulatory complexity.

State Licensure Clinicians generally must be appropriately licensed or otherwise authorized to practice in the jurisdiction where the patient is located, subject to applicable state laws, compacts, and exceptions. If you plan to practice across state lines, evaluate licensing requirements for each target state.

Controlled-Substance Prescribing Controlled-substance prescribing through telehealth is subject to federal and state requirements that can change over time. Review current DEA requirements and applicable state law before offering these services.

HIPAA Compliance Covered entities and business associates must meet applicable HIPAA requirements. Telehealth practices should evaluate privacy, security, vendor agreements, policies, procedures, and workforce training as part of their compliance program.

Corporate Practice of Medicine (CPOM) Some states restrict who may own or control certain medical practices. Review the CPOM and professional-practice rules that apply in your target states before finalizing your structure.

Step 4: Technology Selection

Your technology infrastructure is the operational backbone of a telehealth practice. Poor technology decisions can create bottlenecks, compliance risk, and patient-experience problems that compound over time.

Electronic Health Record (EHR) Choose an EHR that fits your clinical and operational workflow. Evaluate telehealth integration, patient portal capability, billing functionality, interoperability, security, and vendor support.

Telehealth Platform Evaluate telehealth technology for privacy and security requirements, connection reliability, ease of use, and integration with your broader technology stack.

Practice Management and Billing Your billing system affects how efficiently you submit, track, and reconcile claims and patient payments. Evaluate claims management, denial tracking, reporting, and workflow fit.

Patient Communication Secure messaging, appointment reminders, and digital intake workflows can improve the operational consistency of a virtual practice when implemented appropriately.

Step 5: Credentialing

Credentialing is the process by which payers and other organizations verify professional qualifications and determine participation or enrollment status. Timelines vary considerably by payer, market, specialty, and application completeness.

Key points:

• Start early if insurance participation is part of your launch model
• Track each payer's requirements and application status separately
• Understand the distinction between credentialing, enrollment, contracting, and privileging where applicable
• Consider experienced credentialing support when the process exceeds your internal capacity

If you plan to launch direct-pay first and add insurance later, build the future credentialing timeline into your operating plan.

Step 6: Marketing and Patient Acquisition

A telehealth practice needs a deliberate patient-acquisition strategy, not simply a website and hope that patients will find it.

Your Practice Identity What is your positioning? What makes your practice different? Who are you, and why should a patient choose you over another provider? These are strategic questions with direct marketing implications.

Digital Presence A professional website with clear service descriptions, scheduling functionality, and patient education content can form the foundation of your digital presence. Depending on your model, SEO, directory listings, paid media, partnerships, and local visibility may also support growth.

Referral Strategy Referrals can be an important patient-acquisition channel for many practices. Build relationships intentionally with appropriate healthcare professionals, organizations, and community partners.

Content and Authority Publishing educational content — blog posts, social media, and email communications — can help establish credibility and keep your practice visible to potential patients and referral partners.

Step 7: Common Mistakes to Avoid

Drawing on more than 25 years in healthcare and her experience as a clinician, practice founder, and business educator, Dr. Haymond has seen recurring challenges that can derail new telehealth practices.

Underestimating startup costs. Technology, licensing, malpractice insurance, legal fees, and marketing can all require capital before meaningful revenue begins.

Launching without a compliance framework. Build compliance into the practice from the beginning rather than treating it as an afterthought.

Choosing the wrong EHR. Switching EHR systems can be disruptive. Evaluate carefully before committing to a platform.

Skipping the business plan. Skipping structured planning can lead to expensive decisions and slower course correction.

Underpricing services. Know your costs, capacity, payer economics, and revenue requirements before finalizing your pricing model.

The TELEHEALTH Method™

Everything described in this guide is organized within The TELEHEALTH Method™ — a proprietary 10-step executive framework developed by Dr. Charlene Haymond from 25+ years of clinical practice and healthcare entrepreneurship.

The Method provides a structured, sequential approach to major dimensions of building and leading a telehealth organization — from the foundational CEO mindset shift to long-term enterprise sustainability.

T — Think Like a CEO
E — Establish Your Foundation
L — Launch Your Practice
E — Engage Your Patients
H — Harness Technology
E — Expand Your Services
A — Automate Your Operations
L — Lead Your Team
T — Track Your Growth
H — Harvest Long-Term Success

Your Next Step

If you are ready to build your telehealth practice with a structured framework behind you:

• Read the flagship guide: The Telehealth CEO™: Enterprise Edition provides the strategic framework for building, leading, and scaling a healthcare organization.
• Implement with the workbook: The Executive Workbook converts the book's frameworks into guided exercises and implementation work.
• Get personal guidance: Consulting with Dr. Haymond provides direct strategic support grounded in her healthcare and practice-building experience.
• Explore the Academy: The Telehealth CEO™ Academy provides structured business education for healthcare professionals building and leading healthcare organizations.

You have the clinical skills. The business of telehealth is learnable — and the frameworks are here.