How to Start a Telemedicine Practice as a Nurse Practitioner: 11 Helpful Steps for 2024

Telehealth nursing is on the rise as more patients seek convenient access to quality healthcare. Nurses with entrepreneurial spirit have a prime opportunity to launch their own telehealth business and help meet growing demand.

With careful planning and preparation start a telehealth business, 2024 can be the year you start a thriving telehealth business or nursing practice.

Follow these 11 helpful steps on:

How to Start a Telemedicine Practice as a Nurse Practitioner

How to Start a Telemedicine Practice as a Nurse Practitioner

1. Research Your Niche

The telehealth nursing field is broad, so the first step is identifying your niche. Consider specialties like:

  • Telepsychiatry nursing

  • Teledermatology nursing

  • Telecardiology nursing

  • Telepediatrics nursing

  • Teleoncology nursing

  • Telewound care nursing

  • Teleopthalmology nursing

  • Teleurology nursing

  • Telegeriatrics nursing

  • Telehome health nursing

  • Teleschool nursing

  • Teleacute care nursing

  • Telehealth for Chronic disease management (diabetes, hypertension, etc.)

  • Health and wellness coaching (weight loss, smoking cessation, lifestyle changes)

    Telemedicine Practice

Conduct thorough market research around the patient demand in your chosen niche. Examine any competitors or existing healthcare providers serving that specialty in your geographic area. Identify gaps where you can differentiate yourself and provide value.

Choose a focus area that closely aligns with your professional interests, experience and capabilities. Specializing in a niche helps you market specifically to ideal patients versus trying to be everything for everyone.

Stand out with your unique telehealth nursing expertise.

2. Obtain Necessary Credentials

Once you solidify your specialty, confirm what credentials are legally required to provide your desired telehealth services in your state. Typical medical licensing requirements for telehealth nurses are:

Active registered nurse (RN) license

Licensed practical nurses have more limitations in scope of virtual health care providers. Having RN status provides maximal flexibility. Confirm your nursing license covers telehealth programs and the state(s) where you’ll provide care.

Nurse practitioner (NP) certification

If you plan to diagnose conditions, prescribe medications, and otherwise practice medicine at an advanced level. Not all states grant full practice authority to NPs so review regulations.

Professional liability insurance

Most policies for healthcare providers cover telehealth services but verify appropriate coverage from your healthcare provider first.

State telehealth license or waiver

Many states require a special license or waiver to provide telehealth care across state lines. Some states participate in licensure compacts that simplify the process.

Licensure from state medical boards

This applies more if you open a broader virtual care practice as a physician, physician assistant, psychologist, therapist, or other specialist. Verify what board oversight applies for your profession and location.

How to Start a Telemedicine Practice

Certifications in specialized areas

Gain any credentialing needed for your niche like lactation consultant certification for maternal care, chronic care professional for disease management, etc.

Always review your state’s regulations for telehealth nursing licensure and ensure you meet all requirements before offering services.

Also research any necessary certifications for your specialty and complete requisite education to display your expertise. Proper credentialing gives you and your practice credibility.

3. Develop Your Telehealth Platform

A user-friendly HIPAA-compliant telehealth platform is vital for providing patient care online. You have two main options for your virtual visit technology:

1) Join an established telemedicine business.

Partner with an established, top telemedicin software developmente platform or technology company that provides the telemedicine software platform and infrastructure. Pros are less startup work for you, predictable costs, and built-in technical support. Cons are less control and more revenue sharing.

2) Create your own full telehealth business and technology setup.

If building your own platform, make sure it has essential features like:

Video conferencing software

Secure video conferencing for conducting live video visits

Scheduling Software

Scheduling system for patients to book appointments

Charting system

Charting, documentation, and templates for clinical notes

Secure communication software

Secure messaging for follow-ups and non-urgent questions

Phone apps

Mobile accessibility for providing care on the go

Electronic prescription software

E-prescription capabilities connected to pharmacies

Billing software

Billing system and medical coding tools

Patient Portal

Patient portal and educational resources

Tracking software

Data analytics, reports, and EHR integrations

Start a Telemedicine Practice

Always maintain stringent data security and keep HIPAA regulations and compliance. Stay current on privacy laws and encryption standards. Prioritize your patients’ confidentiality and the safe, ethical handling of their health information. is a secure telehealth video platform with text/audio options and integrations. HIPAA compliant.

another option you can try is Updox. an all-in-one telehealth, video, CRM, intake, and patient engagement platform.

4. Create Standard Processes and Workflows

To provide excellent telehealth care, you need organized structures and workflows in place. Take time early on to establish standard operating procedures surrounding:

Patient Visits

  • Pre-visit prep – What instructions help patients prepare for appointments? How are medications, records, and visit goals handled ahead of time?

  • Visit structure – What is the optimal format for your video visits? Set expectations on length, communication norms, and general flow.

  • Post-visit follow up – How do you summarize, share resources, or follow up after appointments? How soon? By what methods?

  • Medication management – What is the process for e-prescribing and coordinating medication changes?

  • Referrals – When and how are specialist referrals made? How are records exchanged? Who communicates outcomes?

  • Emergencies – What protocols handle urgent situations arising during or outside visits? How are escalations handled?

Clinical Documentation

  • Platform used – Which telehealth tools document patient visits? How is charting completed during and after consultations?

  • Note organization – What templates standardize your clinical documentation and SOAP notes?

  • Privacy compliance – How is documentation handled to maintain HIPAA standards and patient privacy?

Administrative Workflows

  • Scheduling – What are the processes for managing appointment booking and schedule changes? Who oversees the calendar?

  • Billing – What are the step-by-step workflows for insurance claims, coding, reimbursement, and patient payments?

  • Technology – Who manages technical issues, platform updates, data security, and infrastructure? In house or outsourced?

Coordinate team roles for each protocol. Update SOPs as workflows improve. Clear clinical and administrative systems allow you to deliver excellent telehealth nursing care consistently as you grow.

Start a Telemedicine Practice

5. Set Your Fees and Develop Billing Processes

Conduct thorough market research to determine competitive and reasonable pricing for your services. Telehealth appointments generally range from $50-150 per session depending on specialty, length of visit, patient’s insurance coverage, and cost of living in your geographic location.

Some common pricing models include:

Flat fee per telehealth visit

This is the most basic model (e.g. $75 per session)

Subscription packages

Offer monthly or annual subscriptions for unlimited or bulk-visit packages at a discounted rate to encourage patient satisfaction and retention.

Complexity-based fee schedule

Vary prices based on complexity of care and time. A 15-minute quick check-in is less than an hour-long initial intake visit. Create pricing tiers.

Insurance-based rates

If joining insurance networks, you will be constrained to contracted negotiated rates. Signing up for more plans expands patient pool but lowers potential revenue per visit.

Hybrid approaches

Use a combination of fee structures like flat and subscription packages. Offer uninsured patients reasonable self-pay options.

Billing practices largely depend on whether you join insurance networks. Accepting insurance requires credentialing contracts, more administration, and billing know-how.

But it expands your patient population. Alternately, opt out of insurance to set your own rates and bill directly like a concierge medical practice does.

Start a Telemedicine Practice

Most telehealth platforms have integrated billing capabilities or integrations. Ensure yours allows you to:

  • Verify insurance eligibility and benefits

  • File claims electronically

  • Process credit cards for upfront patient data collection

  • Code visits based on care complexity

  • Send invoices and collect patient payments

  • Automate administrative tasks

  • Generate reports for revenue tracking

Master your telehealth program has medical codes and billing procedures for your specialty. Consult a medical billing specialist or management firm if needed. An experienced biller helps maximize collections.

6. Handle Taxes, Business Structure and Finances

When starting any business, it’s important to register properly with state/federal tax agencies and determine the right corporate structure. Common options include:

Sole proprietorship

You and the business are one business entity now. Simplest option but less protection.


Shared ownership with technology partner under signed partnership agreement.

Limited Liability Company (LLC)

Hybrid corporate structure that combines pass-through taxation of sole proprietorship with the liability protections of a corporation. Very common for small businesses.

S Corporation

“S-corp” is a corporation with pass-through taxation. Offers liability protections without double taxation.

C Corporation

Separate corporate entity taxed separately from owners. More complex and double taxation but increased protection.

Consult a tax advisor or accountant to determine the optimal set-up for your business bank account and your goals.

File for a Federal Employer Identification Number (EIN) and register your business name. Set up payroll, accounting, and bookkeeping processes.

Track own telehealth business practice’ revenue and expenses diligently. Deduct allowable telehealth business practice business expenses like insurance, technology fees, platform subscriptions, salaries, marketing, and supplies.

Set funds aside quarterly for estimated income taxes. Work with a financial professional to best manage your own telehealth practice’s finances.

Start a Telemedicine Practice

7. Market Your Telehealth Nursing Services

Creating awareness and attracting your ideal patient population takes savvy marketing strategy. With the telehealth software, you can advertise digitally to expand your geographic reach.

Marketing tactics can include:


Create an informative business website highlighting your services, bio, contact options, and online booking.

Ensure it’s mobile-friendly with clear calls to action. Optimized SEO helps with search rankings and discovery for your business.

Social media

Develop profiles representing your practice on popular platforms like Facebook, Instagram, LinkedIn, and TikTok. Share engaging content daily and advertise to target demographics.

Search engine ads

Tools like Google Ads allow you to promote your site to patients searching relevant keywords like “online therapy”. You only pay when someone clicks your ad.

Print/radio/TV ads

More traditional advertising through newspapers, billboards, magazines, radio spots, or local TV ads. Best for hyperlocal or regional outreach.

Doctor referrals

Educate doctors and clinics on your offerings to drive direct referrals. Create referral pads describing your services.

Community presentations

Offer free talks at local schools, libraries, senior centers, shelters, churches, etc. Build trust and connections.

Digital health networks

Join telehealth directories like Teladoc or MDLive to gain new patient leads seeking online care options.


Run limited-time promotions like free screenings, demo visits, giveaways, or discounted packages to attract new patients.

Emphasize convenience, specialized expertise, and how you help people access quality care remotely. Use clear calls-to-action.

Offer free 15-minute consultations to give prospective patients a risk-free way to try your services. Collect patient testimonials and reviews to build social proof.

Start a Telemedicine Practice

8. Build Your Telehealth Team

Depending on your patient volume goals, consider bringing on additional team members to assist with administrative tasks, complementary services, and clinical collaboration. Potential hires or partners may include:

  • Scheduling coordinator – Manages appointment booking and patient scheduling. Focuses on maximizing convenience for patients and your schedule efficiency.

  • Administrative assistant – Handles paperwork, documentation, data entry, billing, insurance claims, and other backend office tasks to free you up for patient-facing care.

  • IT specialist – Manages the technical aspects like the telehealth software platform, website, cybersecurity protections, and solving issues. Can be full-time or outsourced.

  • Medical biller – As mentioned, an experienced biller helps file insurance claims, follow-up on unpaid bills, rectify errors, and ensure maximal legitimate collections.

  • Complementary providers – Expand your services by partnering with other medical professionals like nutritionists, physical therapists, health coaches, pharmacists, or specialists relevant to your business idea or patient niche. Present a unified team to deliver healthcare services.

  • Nursing/PA support – Bring on additional clinical team members to collaborate and expand how many patients you can serve. Clear roles and responsibilities.

The right hires allow you to keep medical practice as at the top of your license and focus the majority of your time on patient care. Be selective in finding qualified, trustworthy, healthcare industry professionals committed to your medical practice’s mission. Outline agreements clearly.

9. Deliver Excellent Telehealth Patient Experiences

While technology enables telehealth, the human connection makes care exceptional. Some best practices for delivering satisfying patient experiences include:

  • Warm greeting and active listening

    Take a few minutes to build rapport and understand patients’ situations and needs. Remove distractions to be fully present.

  • Clear virtual visit expectations

    Explain the structure of the appointment and your own telehealth implementation processes upfront. Verify comfort with technology.

  • Balance eye contact and notes

    Look directly at the camera regularly while interacting. Let patients know when you’re taking notes.

  • Avoid multitasking

    Focus fully on the visit without checking texts, emails, or charts on other screens.

  • Professional setup

    Have proper lighting, framing, and environment to inspire confidence. Dress professionally.

  • Limit visit interruptions

  • Block time properly in schedule. Silence phones and minimize disruptions during visits.

  • Patient engagement and education

    Provide helpful resources, links, handouts, and follow-ups. Use screen sharing to review materials together.

  • Personable manner

    Convey genuine interest and care. Be attentive to non-verbal cues. Use good humor when appropriate.

  • Prompt follow up

    Follow-up in a timely manner via secure messaging, phone, or patient portal. Quickly refer or escalate any concerns.

  • Seek feedback

    Ask patients for telehealth visit reviews and suggestions. Continuously improve their experience.

Providing personalized, compassionate care is just as important online as in-person. Patients remain people with holistic needs behind their symptoms.

Strive to be fully present, attentive, personable, and thorough during visits to provide satisfying care.

Start a Telemedicine Practice

10. Continuously Refine Systems and Improve Efficiency

Starting out, focus on providing quality care and developing solid processes. Over time, identify opportunities to increase efficiency in clinical and administrative workflows to continually improve.

On the clinical side, look for ways to enhance patient outcomes and visits through clearer protocols, better use of support staff, improved documentation tools, and technology automation.

On the business side, regularly re-evaluate policies around scheduling, billing, insurance, taxes, platform tools, and expenses. Update accordingly.

Use data like visits per day, revenue and expenses per patient, accounts receivable trends, and patient feedback to guide efficiency decisions.

Implement more analytics to track performance. Choose key metrics to monitor weekly and monthly.

Work “smarter not harder” by refining workflows versus just working more hours. Be vigilant against burnout. Set healthy work-life boundaries and manage your schedule sustainably.

Protect time for continuing education and your own self-care – essential for delivering quality telehealth nursing over the long-term.

11. Continue Growing Your Skills and Telehealth Practice

Healthcare changes rapidly. Commit to being a lifelong learner to excel as a telehealth nurse over the long-term.

Stay up-to-date on medical developments in your specialty through reputable journals, online courses, seminars, and fellowships. Seek evidence-based approaches.

Pursue ongoing technology education as well – optimize use of your telehealth platform, learn new tools, and keep current with healthcare tech innovations.

Consider earning an advanced telehealth certification.

Participate in professional associations and online communities to connect with fellow telehealth nurses. Attend telehealth conferences.

Look for mentors and colleagues you can collaborate with. Keep expanding your network and knowledge.

Watch for evolving patient needs and new opportunities. Add specialty services, widen your region, update your technology, or improve patient convenience.

Consider merging practices for greater reach. The telehealth nursing field will continue advancing – make sure your own telehealth practice evolves optimally along with the healthcare industry and shifts. Remain flexible and proactive.

In Summary

Key Steps to Launch a Successful Telehealth Nursing Business in 2024:

1. Identify your niche and obtain credentials

2. Choose and develop user-friendly telehealth platform

3. Establish efficient processes and workflows

4. Determine fair pricing and streamline billing

5. Select optimal business structure and handle finances/taxes

6. Promote services through digital and traditional marketing

7. Build telehealth care team and partnerships

8. Deliver personalized, compassionate patient experiences

9. Continuously improve systems and increase efficiency

10. Pursue ongoing education and skills enhancement

11. Watch industry changes and evolve practice accordingly

With proper planning and preparation, you can start a telehealth nursing practice in 2024 that allows you to deliver convenient quality care while operating a rewarding business. Follow these in-depth steps to launch your successful telehealth practice endeavor and make a difference in patients’ lives.

Frequently Asked Questions

Q: What credentials do I need to start a telehealth nursing practice?

A: At minimum, you need an active RN license, liability insurance that covers telehealth, and any required state telehealth licenses or waivers. If you want to diagnose, prescribe, or practice more independently, you should pursue NP certification.

Q: Does telehealth nursing require special technology?

A: Yes, you need a HIPAA-compliant telemedicine platform, for conducting remote appointments by video/audio and securely communicating with patients. You can partner with an established telemedicine company or develop your own platform.

Q: How much can I earn by starting a telehealth nursing practice?

A: Telehealth nursing income varies widely based on your specialty, billing model, patient volume, credentials, and location. Most charge $50-150 per video visit. Launching your own practice allows you to set rates versus staffing for a larger telemedicine service or corporation.

Q: Can I operate a national telehealth nursing practice?

A: It depends. Most states require telehealth providers to be licensed where the patient is located, which can limit multi-state practices. However, joining interstate licensure compacts can simplify this.

Q: Do I need malpractice insurance tailored to telehealth?

A: Yes, it’s recommended to have professional liability insurance that explicitly covers telehealth services. Verify appropriate coverage with your provider.

Q: What qualifications should my staff have?

A: Carefully vet any staff members like assistants, billers, providers, and partners. Ensure they have any required credentials, specialized training, and telehealth experience.

Q: How long does it take to build a successful telehealth nursing business?

A: It takes 6-12+ months for most practices to become established depending on factors like your specialty, marketing/operational efficiency, credentials, and patient demand. Be patient and focused on providing quality care.

Q: What differentiates successful telehealth nursing practices?

A: Successful telehealth nurses differentiate themselves by specializing in a niche, focusing on personalized compassionate care, using proven marketing tactics, leveraging technology smoothly, and continuously improving their services.

Q: Are there associations tailored to telehealth nursing?

A: Yes, the American Telemedicine Association and the Nursing Organizations Alliance both have special interest groups, resources, and events for telehealth nurses. Seek online communities as well.

Q: What ongoing learning helps refine my telehealth nursing practice?

A: Pursue continuing education in your clinical specialty as well as relevant topics like telehealth regulations, virtual visit best practices, digital marketing, practice management, and healthcare tech advances.

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