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For clinicians going from employed to independent

You hold the dial.

Elf maps the whole arc — exit contract, entity, credentialing, first patients — and handles the long-lead items so the income gap is as short as it can be. You set how much you do yourself. You keep every dollar of upside.

Built for MD/DO, NP, PA, and therapists. The credentialing gap runs 90–165 days; Elf starts the clock the day you sign up.

Your involvement
OperatorA balanced split — you steer; Elf preps, our team executes.
50%
Payer enrollment & follow-upsOur team
Entity, EIN & licensing prepElf
Phones, scheduling & intakeYou
Vendor calls & portal loginsYou

Turn the dial up and the cash-gap valley gets shallower — Elf and our team carry more of the build. Your price scales with the dial — never with your revenue.

Typical research puts the cash gap around $90k–$450k over ~90–180 days. Estimate based on your inputs and typical timelines — not a promise. We refine it as we learn more.

90–180
Days, typically, between your last paycheck and your first paid claim
$90k–$450k
Typical cash-flow valley during the gap
5 lanes
Exit → Launch → Fill → Sustain → Grow on one board
0%
Revenue share — flat fee only, every tier, always
400+
Providers credentialed
by the PPS team behind Elf
51
Steps on one board
exit through first paid claim
$0
Revenue share taken
flat fee · you keep every dollar
Day 1
Credentialing starts
not week 6 like most practices
The first 180 days

What going independent actually looks like.

The income gap is real — credentialing takes 90–165 days before payers start paying. Elf starts the long-lead items the day you sign up so the valley is as short as it can be.

Weeks 1–4Exit & entity
  • Counsel reviews your employment contract & non-compete scope
  • Elf estimates your valley — overhead × credentialing months
  • Elf preps your PLLC filing and EIN application — file it yourself, or hand it to our team
  • You set your resignation date
Month 1–2Credentialing starts
  • Elf builds your CAQH + PECOS packets — submitted by you, or by our team on Done-with-you and up
  • Elf preps applications for BCBS, Aetna, Cigna, UHC, and Medicaid
  • You secure tail malpractice before your last day
  • Elf drafts your site & listings — built and claimed for you on Done-for-you
Month 2–5The valley
  • Overhead runs. Payers are reviewing — not paying yet.
  • Elf tracks every payer and drafts the follow-ups; turn up the dial and our team works the calls
  • You see patients and collect at the visit while credentialing clears
  • Elf models your runway so you can see when cash likely turns positive — an estimate that sharpens as real numbers land
Month 5–6+Past the valley
  • Biller submits first claims — payers start paying
  • Elf flags slow payers and filing deadlines before they quietly expire
  • Elf reminds you ahead of every CAQH re-attestation, license, and DEA renewal
  • You own the practice, the patients, and every dollar of revenue

Timeline is typical for a physician in a non-rural market. Credentialing lag depends on specialty, state, and payer. Elf starts the longest-lead items first so nothing waits unnecessarily.

Mission control

The whole arc, on one board.

Exit, Launch, Fill, Sustain, Grow — every task carries a status and an owner, so you always know what is moving and who has it. Some tasks wait on a third party; Elf tracks those too.

Stage 01

Exit

Review your employment & non-compete terms
DoneCounsel
Notice timeline & handoff plan
In progressYou
Stage 02

Launch

Form the entity & file for EIN
DoneElf
State medical license update
Waiting on third partyElf
Brand, site & phone line live
In progressElf
Stage 03

Fill

Payer enrollment & credentialing
Waiting on third partyElf
Scheduling & new-patient intake flow
In progressElf
Local referral outreach
QueuedYou
Stage 04

Sustain

Claims submitted & tracked
In progressBiller
Overdue payers flagged & followed up
In progressElf
Monthly owner dashboard
QueuedElf
Stage 05

Grow

Payer rate audit — are you being paid fairly?
QueuedElf
Referral network & local marketing
QueuedElf
Online reviews & patient satisfaction
QueuedElf

Elf tracks every payer, flags overdue ones, and drafts the follow-up; turn up the dial and our team works the calls and portals.

Beyond launch

The valley is just the start.

Crossing the credentialing gap gets you open — but the first 18 months are where most independents quietly bleed margin. Elf doesn't stop at go-live: it models the climb, then helps you run the business.

break-eventhe valleyyour first profitable year →

Illustrative — your curve depends on specialty, payer mix, and overhead. Elf models it from your inputs; an estimate, not a promise.

After launch, Elf is the single place your practice runs from — money, operations, marketing, and growth on one board. One brain for your business. Dial up what Elf and our team handle; dial down what you keep.

Sustain — keep it running
  • Billing & revenue cycle — claims, denials, and aging AR worked so nothing slips.
  • Bookkeeping & cost-of-business — the books kept, and overspend flagged early.
  • Renewals & re-attestation — CAQH, payer revalidation, licenses on one calendar.
  • Messaging & appointment reminders — fewer no-shows, less phone tag.
  • Scheduling & intake — a front desk that always answers.
  • Year-one model — your runway, overhead, and real break-even, mapped.
Grow — fill it & expand
  • Local SEO & your website — get found the moment a patient searches.
  • Social & content — a steady presence, written and posted for you.
  • Video & reels — edited clips from a phone recording.
  • Reviews & reputation — asked for, monitored, and answered.
  • Referral relationships — the local network that sends the right cases.
  • Hire / second location — the next step modeled before you commit.

You've launched — now what?

01 · OpenDoors openSeeing patients — but not paid yet. Elf tracks the credentialing and drafts every follow-up so the wait is as short as it can be.
02 · FillFirst claims clearPayers start paying; the trough bottoms out. Elf flags denials early so nothing ages out.
03 · ClimbAcross break-evenRevenue covers overhead. Elf watches cost-of-doing-business so margin doesn't leak.
04 · GrowSteady & growingHire, add a service line, open a second location — modeled before you commit, on your timing.

The dial keeps working after launch — turn it up and Elf and our team carry bookkeeping, RCM, scheduling, and more. You stay in control.

Next best action

The one thing that moves you forward today.

Elf reads the whole board and surfaces a single step — so independence is never an overwhelming to-do list. Today: confirm your target launch month so payer enrollment can start (it has the longest lead time).

Start your free Exit Readiness checkSee Elf in action →
How we charge

Aligned with you owning it — not with what you earn.

Flat fee. We never take a percentage of your practice. When you grow, you keep all of it.

  • The dial sets your price. Hand more to our team and the fee reflects that work — your revenue never enters the math.
  • You own the entity, the patient relationships, and every dollar of upside. Elf runs the back-office and setup of your practice — you own it and stay in control.
  • Turn the dial down whenever you want to take the wheel back. No lock-in to a single way of working.
Early access

What clinicians said after their first week.

  • I delayed six months trying to make sense of my non-compete and the credentialing timeline. Elf organized the exit checklist, ran the valley numbers, and pointed me to counsel for the contract — I had a clear plan in two days. I gave notice the following week.

    Family Medicine MDOregon · leaving a 3-physician group

  • The CAQH profile was the part I kept putting off. Elf broke it into a checklist — every field, every required attachment, which payers wanted what in what order. The thing I'd avoided for months took a weekend.

    Nurse Practitioner, Family PracticeColorado · solo telehealth + office practice

  • I thought I needed $200,000 saved before I could leave. The valley calculator showed me my break-even with a 70% cash-pay mix was under $40,000 at my overhead. That math changed everything about my timeline.

    Licensed Professional CounselorTexas · transitioning to private practice
Free · no card · 1 business day

See your number before you give notice.

Tell Elf a few things and we'll come back with your Exit Readiness check — your valley estimate, the credentialing timeline, and the first moves to make.

Estimate based on your inputs and typical timelines — not a promise. We refine it as we learn more.