starting private practice in Massachusetts

[psychinmassachusetts]

Hi, I’ve been on this forum for years and it has helped me a lot throughout my career. I finally decided to change my job and start a private practice. It will be all online (for now at least) and still in the early stages. I’ve been told that many people start out as part time and in the meantime have a full time job. What do people do for their other job? Is it a conflict to work at another private practice part time and also have my own? If not, are you transparent and tell the potential employer about it?
I am looking for new jobs and so many options include group practices, etc. and I just want to make sure.

I have so many specific questions (related to city license, LLCs,) about starting a private practice in MA but am having a hard time finding answers. Is anyone aware of coach or consultant that can assist?


Thank you 🙂

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[WisNeuro]

I have so many specific questions (related to city license, LLCs,) about starting a private practice in MA but am having a hard time finding answers. Is anyone aware of coach or consultant that can assist?

Definitely get these questions answered before doing any actual work private practice-related. You don't want to start practice and find out down the line you're technically breaking the law.

 

[Therapist4Chnge]

Your state psych association may have private practice resources and/or a group/e-mail list that deals with PP issues. I'd strongly recommend consulting with others locally before jumping in because there can be a lot of little things, some are state dependent.

 

[PsyDr]

1) Usually, the concern about being employed and having your own PP is that you are potentially competing with your employer. There are ways around this.
2) To get an LLC, first get a PO box at one of those UPS stores that gives you a physical address (not USPS). Then hire an attorney to create an LLC (not online). Use the PO box as the address. Total cost should be sub $1000. This will provide you with an LLC, articles of incorporation, and sometimes an EIN with the IRS. If you look at MA's commerce department, they have a listing for the required fees. Those go to the state. Everything else goes to the attorney. Take the EIN, go to your bank, open an account for your LLC. Now go to mass.gov, and get a MA business license. They will ask for the above. Now google NPI type II. Create a type 2 NPI under your LLC and your new business address. Then start applying for insurance companies to empanel you. Get malpractice insurance. Figure out where to see patients. Change your business address to there. Get an EMR. Submit bills through there. Get paid into your LLC. Write yourself a check every month. Wait several years. Get a bradford score. Then get a business line of credit, even if you don't need it. Put 25% of your earnings into a SEP IRA. Retire well.

 

[WisNeuro]

OP, get liability insurance. Don't be a *****.

 

[psychinmassachusetts]

1) Usually, the concern about being employed and having your own PP is that you are potentially competing with your employer. There are ways around this.
2) To get an LLC, first get a PO box at one of those UPS stores that gives you a physical address (not USPS). Then hire an attorney to create an LLC (not online). Use the PO box as the address. Total cost should be sub $1000. This will provide you with an LLC, articles of incorporation, and sometimes an EIN with the IRS. If you look at MA's commerce department, they have a listing for the required fees. Those go to the state. Everything else goes to the attorney. Take the EIN, go to your bank, open an account for your LLC. Now go to mass.gov, and get a MA business license. They will ask for the above. Now google NPI type II. Create a type 2 NPI under your LLC and your new business address. Then start applying for insurance companies to empanel you. Get malpractice insurance. Figure out where to see patients. Change your business address to there. Get an EMR. Submit bills through there. Get paid into your LLC. Write yourself a check every month. Wait several years. Get a bradford score. Then get a business line of credit, even if you don't need it. Put 25% of your earnings into a SEP IRA. Retire well.

Thank you so much for this.



Thank you all for your input! Greatly appreciate it.

 

[PsyDr]

I've had my PP for about 20 years for secondary income. I never got liability insurance, never paid a lawyer or CPA to handle anything, did my own simple bookkeeping, did my own tax returns, never accepted insurance, wrote my notes by hand, never incorporated, never used an NPI. My simple point being: you don't have to make it overly-complex. I've made a very decent income, was able to purchase multiple homes in a major US city, still take 3 or 4 long trips per year, yada, yada, yada...

there’s doing it the right way, and just taking a risk because “what’s the worst that could happen”?

 

[clausewitz2]

there’s doing it the right way, and just taking a risk because “what’s the worst that could happen”?

Neither Siegfried nor Roy gotten mauled by tigers on the overwhelming majority of days they showed up to work, after all.

 

[Sanman]

I've had my PP for about 20 years for secondary income. I never got liability insurance, never paid a lawyer or CPA to handle anything, did my own simple bookkeeping, did my own tax returns, never accepted insurance, wrote my notes by hand, never incorporated, never used an NPI. My simple point being: you don't have to make it overly-complex. I've made a very decent income, was able to purchase multiple homes in a major US city, still take 3 or 4 long trips per year, yada, yada, yada...

You owned multiple homes, but never felt the need to get liability insurance for your practice? That seems like a risk I would never want to take.

 

[DaphneDoc]

1) Usually, the concern about being employed and having your own PP is that you are potentially competing with your employer. There are ways around this.
2) To get an LLC, first get a PO box at one of those UPS stores that gives you a physical address (not USPS). Then hire an attorney to create an LLC (not online). Use the PO box as the address. Total cost should be sub $1000. This will provide you with an LLC, articles of incorporation, and sometimes an EIN with the IRS. If you look at MA's commerce department, they have a listing for the required fees. Those go to the state. Everything else goes to the attorney. Take the EIN, go to your bank, open an account for your LLC. Now go to mass.gov, and get a MA business license. They will ask for the above. Now google NPI type II. Create a type 2 NPI under your LLC and your new business address. Then start applying for insurance companies to empanel you. Get malpractice insurance. Figure out where to see patients. Change your business address to there. Get an EMR. Submit bills through there. Get paid into your LLC. Write yourself a check every month. Wait several years. Get a bradford score. Then get a business line of credit, even if you don't need it. Put 25% of your earnings into a SEP IRA. Retire well.

Only thing I would add is make sure the words on every document match *exactly*.... Omission of a word, such as "The," or use of "&" vs. "and" , or use of ,LLC after your title in one place vs. the other can cause you to go in circles endlessly...

 

[summerbabe]

You owned multiple homes, but never felt the need to get liability insurance for your practice? That seems like a risk I would never want to take.

Theoretical orientation: YOLO!

The VA and how we don’t really have to worry about normal tort precedent has spoiled me but if I ever go into PP, I’m definitely loading up on insurance.

 

[oldschooliscool]

1) Usually, the concern about being employed and having your own PP is that you are potentially competing with your employer. There are ways around this.
2) To get an LLC, first get a PO box at one of those UPS stores that gives you a physical address (not USPS). Then hire an attorney to create an LLC (not online). Use the PO box as the address. Total cost should be sub $1000. This will provide you with an LLC, articles of incorporation, and sometimes an EIN with the IRS. If you look at MA's commerce department, they have a listing for the required fees. Those go to the state. Everything else goes to the attorney. Take the EIN, go to your bank, open an account for your LLC. Now go to mass.gov, and get a MA business license. They will ask for the above. Now google NPI type II. Create a type 2 NPI under your LLC and your new business address. Then start applying for insurance companies to empanel you. Get malpractice insurance. Figure out where to see patients. Change your business address to there. Get an EMR. Submit bills through there. Get paid into your LLC. Write yourself a check every month. Wait several years. Get a bradford score. Then get a business line of credit, even if you don't need it. Put 25% of your earnings into a SEP IRA. Retire well.

Thank you for making this step-by-step, I saved it!

 

[smalltownpsych]

1) Usually, the concern about being employed and having your own PP is that you are potentially competing with your employer. There are ways around this.
2) To get an LLC, first get a PO box at one of those UPS stores that gives you a physical address (not USPS). Then hire an attorney to create an LLC (not online). Use the PO box as the address. Total cost should be sub $1000. This will provide you with an LLC, articles of incorporation, and sometimes an EIN with the IRS. If you look at MA's commerce department, they have a listing for the required fees. Those go to the state. Everything else goes to the attorney. Take the EIN, go to your bank, open an account for your LLC. Now go to mass.gov, and get a MA business license. They will ask for the above. Now google NPI type II. Create a type 2 NPI under your LLC and your new business address. Then start applying for insurance companies to empanel you. Get malpractice insurance. Figure out where to see patients. Change your business address to there. Get an EMR. Submit bills through there. Get paid into your LLC. Write yourself a check every month. Wait several years. Get a bradford score. Then get a business line of credit, even if you don't need it. Put 25% of your earnings into a SEP IRA. Retire well.

This is pretty much what we did except we used our accountant to help setup the business instead of an attorney. We also have a few layers of insurance and it’s relatively cheap to insure the business and an umbrella policy for our personal assets in addition to malpractice insurance of course. Now I just need to figure out what a Bradford score is and get a line of credit. The IRA I already have but haven’t started socking money away yet. Mainly because our bank account was not growing. That is happening this year. 😀

 

[deleted1129370]

Hi, I’ve been on this forum for years and it has helped me a lot throughout my career. I finally decided to change my job and start a private practice. It will be all online (for now at least) and still in the early stages. I’ve been told that many people start out as part time and in the meantime have a full time job. What do people do for their other job? Is it a conflict to work at another private practice part time and also have my own? If not, are you transparent and tell the potential employer about it?
I am looking for new jobs and so many options include group practices, etc. and I just want to make sure.

I have so many specific questions (related to city license, LLCs,) about starting a private practice in MA but am having a hard time finding answers. Is anyone aware of coach or consultant that can assist?


Thank you 🙂

I have a consulting business and this is what I work with my clients on.