A. This is a difficult question to answer easily. The general answer to this question is any where from 60-120 days from the date of your first billable anesthesia service. There are however, multiple circumstances that will impact this cash flow development timeline. The greatest impact will come from your preparedness to work with the managed care providers that you have identified are present within your marketplace. Planning for practice implementation can not be stressed more. A rule of thumb used by BCS is that we need to allow for at least 90 days for the contracted managed care payers to process all of the group’s provider’s credentials and set the group / providers up as participating with a particular managed care plan. This 90 day timeline starts once the carrier receives all of the group/provider’s credentials. Remember retroactive billing after participation is granted is generally not allowed. Anesthesia services provided prior to your group’s effective participation date will more than likely be uncollectable.