Scrubs to Startup, business launch for nurse entrepreneurs
No patient contact

Utilization review, remote and in demand.

Payers, providers and third party administrators need clinical review of medical necessity. It is document based, remote and built on criteria sets you already understand.

See our packagesBook a call

Go-Live, $4,500. Every price is on this page. Two builds a month, waitlist beyond.

Utilization review consulting, by the numbers

Typical startup cost

Under $1,000

What reviewers charge

$75 to $150 an hour

Realistic time to first client

One to three months

Typical market ranges, not a promise of earnings. Your state, your market and your pricing decide the real numbers.

Before you can open

Criteria knowledge and secure handling.

Buyers are institutional. They will audit your process before they send you a single case.

Business entity

You do this

An LLC and an EIN. Institutional buyers will not pay a personal account.

Criteria set familiarity

You do this

InterQual, MCG or payer specific. This is the skill being bought.

Secure document handling

We do this

Encrypted intake, storage and retention policy. Their compliance team will ask.

Contracting and invoicing that payers accept

We do this

Purchase orders, net terms and W-9 handling.

Turnaround commitments in writing

We do this

Volume, turnaround and escalation. Contracts hang on these.

A buyer list

You do this

Payers, TPAs, IPAs, hospitals and review vendors.

Can you own a utilization review practice in your state?

Not clinical practice, so no professional entity and no medical director. Some payer contracts require specific certifications and licensure in particular states, which is a contract requirement rather than an ownership one.

Check your state, free

Pricing, published

What we build for a utilization review practice.

Your track is decided by what the business actually does, not by your budget. Published scope caps and a written not-included list, every time.

Your track

4 weeks

Go-Live, Consultancy

$4,500

or 6 payments of $750

Everything an expertise business needs to be hired: credibility with your buyer, the intake and proposal flow, the pipeline and the invoicing.

Credibility architecture aimed at your buyer, not at patients
Case and client intake built for how the work arrives
Proposal and engagement-letter flow
Pipeline CRM and retainer invoicing
Work-product templates for your discipline
A walkthrough library so you can run it yourself
Published scope caps and a written not-included list
Ninety days of Rounds included
Start Go-Live, Consultancy

75 minutes

The Report

$350

$175 credits toward Go-Live within 30 days

Before you commit to a build: one session that walks your whole intended operation and tells you plainly whether a utilization review practice is the right thing to open.

Licensure and model: whether you can own it, and as what
Offer and pricing, walked properly rather than guessed
The client journey, end to end
The tech stack you actually need, and what to skip
Your launch sequence, in order
One page summary and the recording within 48 hours
Book The Report

Fifty percent to book, fifty before launch, or six monthly payments at the same total. Interest free, never a discount. Every Go-Live includes ninety days of Rounds, then $179 a month if you keep it. All services and add-ons.

Questions nurses ask about a utilization review practice.

Not always, but some payer contracts specify it. Worth checking against the buyers you actually want before spending on an exam.

Related but distinct. Utilization review is about medical necessity against criteria. Chart review is broader and often litigation driven.

Yes, and many do. Volumes are negotiated, which makes it one of the more controllable models around a rota.

Mostly review vendors and TPAs rather than payers directly, at least at first. That is where the outreach should point.

Ready to take your first contract?

Fifteen minutes with a fellow nurse who has built nurse-led businesses, not a coach. The prices are already on this page, so the call is not a pitch.

Book the free callFree Scope Check

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