A single owner llc will not protect you for taxes, business liabilities, etc. the IRS treats a single owner llc as a pass through entity. Most offices require a personal guarantee to rent, so the llc won't help. For liability, the llc only protects you if it the actions of the other employees of the llc. It does not protect you in the event of malpractice.
There are several strategies which do help with this stuff. But you have to find some fairly expensive professionals to help you. Depending on your state, marital status, assets, etc he options are multiple tiered llcs, s corps, flps, irrevocable trusts, etc.
You're gonna need $5-40k in startup.
1) prepare yourself financially. Increase your lines of credit, get a mortgage if you don't have one already. Mortgages for the self employed require a minimum of 2 years of tax returns.
2) go to a GOOD attorney. Create an llc. Do not do an online cheapo llc formation. This one expense has implications for your taxes, credit, and liabilities. Wanna get sued for a few million and have some loopholes in the articles of incorporation? You'll get a tax id number here. Good because this is gonna go on a ton of documents. You're looking at a few grand here. And around $10k in startup funding, which you'll need to avoid piercing the corporate veil.
3) with #2, go to the bank and create a business bank account. Business lines of credit do not count towards your personal credit score.
4) get a business address. Keep in mind you're cash flow negative now. Yes, you need the address FIRST. You'll need to learn the term "Nnn" or triple net
And what it means. Office rent is usually expressed in price/sq ft and NNn. The latter is variable, but you can ask for previous year estimates. An office with a fountain in the lobby might look nice, but there are nnn implications.
5) phone, computer, fax machine (fax is incredibly important even though you'd think 1800s technology isn't. And yes, fax machines are that old). Office furniture, etc. make sure everything is ada compliant. This includes doorknobs. There are people that sue for this stuff, for a living. DO NOT USE PERSONAL FUNDING TO BUY THIS. You'll pierce the corporate veil. Accounting software is pretty handy. Some higher end credit cards can export directly to the software.
6) buy malpractice insurance, knowing it gets more expensive every year.
7) buy office insurance also. This covers you if someone falls in your office. Actually happened to a friend of mine. One jerk tried to do something similar to me because he got a static shock in my parking lot. Not even joking.
8) create a clinic npi. This is where ou need the business address. You only bill as a clinic now. Change the address on your personal npi of you can. Cms has a guide on when you can change addresses and when you have to create a new one. Locums stuff is a good way to understand this.
9) using #9 and # 3 apply to insurance panels using the clinic npi and your personal npi. Wait 2-6 months. Yes it takes that long to hear back.
10) Find a credit card service to take payment. Costco is recommended.
11) Billing is a nightmare. You are not going to get it right for a long time. You should absolutely plan on long stretches of time with no income. Audits happen and sometimes they freeze sending stuff while the audits underway. Call around for billing companies. Many are not going to take you on a client. I was told that most didn't take anyone on with less than $1mill in billables. Some take up to a 25% cut.
12) find a great cpa. You now pay quarterly taxes. Since you're self employed, your income is variable. The IRS does not care. They assume you make 20% more each year. Don't have it? You still owe it. For example: if your estimated quarterly payment is $40k and you only made $30k overall that quarter; you'd still owe $40k which won't be corrected until April.
13) find a financial planner. For the first year, a SEP ira is a pretty good choice. You can put away around $49k/year tax deferred. Means in 15 years, you're a millionaire. But you'll need further panning if you want to ever buy a house, car, retire, etc. remember there will be times you make a bunch and times when you loss money just by being open. And none of this is predictable or scheduled. When I first started out, a client owed me a ton of money and wouldn't pay for 6 months.
14) expect to spend around 8hrs/wk on the business stuff. Keeping track of expenses is key. So is returning phone calls. Figure out your daily cost of doing business. There is a cost for each day you are open which includes taxes, rent, employees, utilities, etc. Helps to know how much you need to earn each day. If you have employees, you need to know how much profit you make off each. My annual operating cost, when I had a staff, was well into the six figures.
15) Learn about what posters are required in your state. Yes, you have to buy posters that show state and federal laws and there are fines if you don't have them. Amazon is your friend. There are inspectors which show up.
16) If you hire staff, which you should not do for the first few years, learn about workers comp and unemployment stuff.
