🏛️ Policy & Payers

📈 Business & Tech

⭐ Just for Fun

If you’re considering opening a second location, you’re not alone. There are now more than 3,100 dermatology group practices in the U.S., many expanding to meet rising demand. But with every new site comes complexity — more workflows, payer contracts, and credentialing timelines. 

With the right fundamentals in place, expansion can strengthen your practice instead of straining it.

So where should you start? With the market itself.

Before you start scouting leases, dive into the data. Run a payer mix analysis to understand how your revenue could vary by market. Commercial-heavy areas tend to bring steadier reimbursement, while government-heavy regions can mean tighter margins.

Then look at the competition. How many dermatologists already serve the area? A saturated market can make it tough to gain traction, so where are patients still waiting weeks for appointments or driving across town for care?

And don’t forget your referral network. Primary care offices, med spas, and specialty clinics nearby can help keep your schedule full. If you offer niche services like Mohs or pediatric dermatology, check whether those cases are leaving the area. That’s opportunity knocking.

Once you’ve identified the right market, it’s time to make sure payers are ready to follow.

Once you’ve secured your new space, reach out to each payer early to confirm what’s needed to add another site. The process isn’t identical from plan to plan, and small oversights here can delay reimbursement later.

While adding a location is usually simpler than credentialing new providers, it still takes time. Submit updates as soon as your lease is signed, and verify that every provider is linked correctly in each payer’s system.

If you’re expanding into a new state, expect a reset. Contracts don’t always transfer across regions, so give yourself a longer runway.

And once the payer side is buttoned up, turn to your systems. Expansion runs smoothly only when billing and operations move together.

When billing lives in silos, visibility disappears fast. If each office runs its own workflow, you won’t spot leaks until cash flow dips, and by then, it’s usually too late.

The fix? Bring everything under one roof. Use a single practice management or EHR platform for scheduling, billing, and reporting so every claim moves through the same process.

If a full integration isn’t possible, focus on consistency. Standardize what you can: charge capture, posting, verification. Even small differences add up. Keep a close eye on metrics by site including A/R, denials, and collections. When benchmarks shift, it’s your cue to investigate.

Technology can only take you so far though. Your team has to scale with it, and your marketing should too. Once your new site is ready, engage existing patients early, share updates across your channels, and build awareness through local marketing and outreach. A little proactive communication helps ensure the new location opens with steady volume and visibility.

But volume means little without the right support behind it. That’s where your team comes in.

Start with who you have. Cross-train existing team members and rotate them between locations before adding new hires. It keeps costs predictable and culture consistent. When you do bring on staff, scale gradually. Over-hiring early leads to idle time and inflated payroll that’s hard to unwind.

Retention matters just as much. Front-office churn is high across healthcare, and new locations can stretch your best people thin. Invest in training and communication early to keep your team steady as volume ramps up.

And as you scale, pay attention to what the numbers are telling you.

Expansion strain shows up before it hits your revenue. Here’s what to watch for:

Your A/R is creeping up. If days in A/R rise above 40 or more than 10% of balances age past 90 days, dig in. It could be claim errors, process gaps, or under-resourced billing.

Denials are spiking. Review top denial reasons weekly and fix the patterns fast.

Your team is tired. Burnout, absenteeism, and errors mean workloads need rebalancing.

Patients are frustrated. Complaints about billing or wait times usually signal workflow cracks.

Set up a simple dashboard to track these KPIs weekly. Early intervention, whether adding billing support or tightening workflows, keeps small problems from becoming margin-killers.

Expansion moves fast, but taking time to double-check your setup can save months of cleanup later. Use this quick readiness checklist to make sure the fundamentals are in place before patients walk through the door:

When you're ready for an expert to make your practice's billing bulletproof, schedule a strategy call with our team.

This one was super fun. Hope you enjoyed it too.