What do I do now?

[ODhopeful]

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Hi,

I have just graduated this past May and have been working for other doctors as independent contractors. My question is that, should I be applying for medicare, NPI numbers, vision insurances, or anything right now? Or do I need to wait until I have my own business to start applying to become providers of different insurances. I apologize if this is a dumb question, but I've just started working and am wondering what should I be doing next to further my career. Any suggestion/recommendation would be appreciated. Thanks.

 

[4Eyes]

You'll absolutely need an NPI for pretty much everything. Do that first. Are you just working odd jobs right now, or have you landed, so to speak? For some of that, you'll need to know where you've landed. So you have an office address, hours, you know whether or not you're reassigning your benefits, etc.

 

[KHE]

Hi,

I have just graduated this past May and have been working for other doctors as independent contractors. My question is that, should I be applying for medicare, NPI numbers, vision insurances, or anything right now? Or do I need to wait until I have my own business to start applying to become providers of different insurances. I apologize if this is a dumb question, but I've just started working and am wondering what should I be doing next to further my career. Any suggestion/recommendation would be appreciated. Thanks.

In general, you should not be working as an independent contractor.

But that aside, start with getting your NPI number and your DEA number. As far as insurance credentialling, the answer really is: it depends on what your long term plans are. Do you plan on staying at any of these locations you're at for the foreseeable future or not?

 

[zyg0te]

Do you mind sharing which school you graduated from?

 

[yOyOYoo]

ODhopeful, congrats on finishing school!! What area are you working in?

I know, depending on the location, finding any jobs may be extremely difficult at this time. At least, this is what I have been hearing from peers in various western state locations. btw, you might want to bookmark this online medicare application for future reference.

Getting your NPI is a good start, it's easy and you can apply online.
You definitely need to get some form of Malpractice Insurance, you can go through MARSH and you should get the highest coverage possible.

If you are only doing "fill-in" work for other doctors, there really is no need to get a DEA number, Medicare, VSP, Eyemed, or other various vision insurance plans. Some pharmacists may give you a hassle for not having a DEA number and writing a script for a topical ophthalmic medication, but it shouldn't be a problem. As far as I am aware, you would only apply for Medicare or other vision service plans once you have a permanent location of practice.

ADDENDUM: If you are doing consistent work for these other doctors, and their offices are accepting vision insurance plans such as VSP, then this would be a GREAT time to also apply for those insurance plans. Reason being that some of those plans you need to be associated with a practice, and can't be just an independent contractor running between different corporate offices.

 

[Meibomian SxN]

Hi,

I have just graduated this past May and have been working for other doctors as independent contractors. My question is that, should I be applying for medicare, NPI numbers, vision insurances, or anything right now? Or do I need to wait until I have my own business to start applying to become providers of different insurances. I apologize if this is a dumb question, but I've just started working and am wondering what should I be doing next to further my career. Any suggestion/recommendation would be appreciated. Thanks.

I've been in your shoes before. Reading the responces seems like many on here are older and giving you bad advice.

1) Get malpractice insurance ASAP but DO NOT get the most expensive one. You have just graduated so try to keep your expenses low. Unless you are working in a high liability practice or doing co-management, you should be fine with just the basic malpractice through MARSH or Zurich. Just try not to spill NaFl on the Px's clothes lol.

2) You DO NOT need a DEA license unless you are going to be prescribing narcotics. At $500, you really don't need it now. Your license is enough to Rx all oral & topicals. If the Px come in and has that much pain then tell them to swallow some APAPs.

3) If the place where you are contracting at accepts insurance it would be easier to apply to all of the insurances you can using their address. Insurance paneling can take a LONG time so get started now, that way when you move on its easier to just change the address.

4) Apply online at the IRS website for a Taxpayer Id Number (TIN). Its free. You will need this when it comes time for taxes (because as a Independant contractor your taxes are not withheld). So DO NOT go on a spending spree. Take 20-25% of your check and put it away in an account because this is what you will have to pay back to Obama.

5) Get an accountant. They will help you with the TIN#, forming your own business entity so that you can start to keep track of and deduct business expenses (lunch, gas, mileage, etc).

Good lucK& congrats!!!

 

[4Eyes]

Just thought I'd chime in again on some other things that have come up in this thread.

About the malpractice insurance. The ones mentioned above are fine. But if you haven't gotten it yet, consider talking to some local insurance companies. I got my malpractice insurance locally and it was actually a little cheaper. I think it's nice to have a good agent you can work with locally.

I don't have a DEA number either. I was worried about dropping that kind of $ right off the bat, but the senior docs in my area said I don't really need one. Occasionally, the pharmacy will call and nag you because it's needed for a patient's insurance. 99.99% of the time, the pharmacy can just use their DEA number. One time I had a pharmacy not do this and the patient was out of pocket. Fortunately, it was an affordable, generic gtt.

I keep 30% in a business account and pay myself 70%. This should give you plenty to pay taxes when the time comes, but I agree an accountant is very helpful. A good accountant will be able to advise you too. 30% may be more than what you really need to set aside, but it's probably a safe number. And you can decide what to do with what's left after taxes. Whether you want to invest it or buy equipment or whatever.

Disclaimer: I've only been out a little over a year, so I'm still learning the ropes too.

 

[ODhopeful]

I've been in your shoes before. Reading the responces seems like many on here are older and giving you bad advice.

1) Get malpractice insurance ASAP but DO NOT get the most expensive one. You have just graduated so try to keep your expenses low. Unless you are working in a high liability practice or doing co-management, you should be fine with just the basic malpractice through MARSH or Zurich. Just try not to spill NaFl on the Px's clothes lol.

2) You DO NOT need a DEA license unless you are going to be prescribing narcotics. At $500, you really don't need it now. Your license is enough to Rx all oral & topicals. If the Px come in and has that much pain then tell them to swallow some APAPs.

3) If the place where you are contracting at accepts insurance it would be easier to apply to all of the insurances you can using their address. Insurance paneling can take a LONG time so get started now, that way when you move on its easier to just change the address.

4) Apply online at the IRS website for a Taxpayer Id Number (TIN). Its free. You will need this when it comes time for taxes (because as a Independant contractor your taxes are not withheld). So DO NOT go on a spending spree. Take 20-25% of your check and put it away in an account because this is what you will have to pay back to Obama.

5) Get an accountant. They will help you with the TIN#, forming your own business entity so that you can start to keep track of and deduct business expenses (lunch, gas, mileage, etc).

Good lucK& congrats!!!

Thank you for the advice. BTW, I graduated from UHCO and working in the Houston area. I applied for a EIN #, so do I still need a TIN #? I'm just confused. The doc I work for owns the lease to the office I work at, but I'm the only person seeing patients here. I'm being paid as a independent contractor even though I'm here every week. He does take some insurance such as BCBS, Aetna, but not medicare. Should I try to ask him to get me on the medical insurance he's currently taking? and if I should try to apply to medicare? Thanks

 

[Ryan_eyeball]

Thank you for the advice. BTW, I graduated from UHCO and working in the Houston area. I applied for a EIN #, so do I still need a TIN #? I'm just confused. The doc I work for owns the lease to the office I work at, but I'm the only person seeing patients here. I'm being paid as a independent contractor even though I'm here every week. He does take some insurance such as BCBS, Aetna, but not medicare. Should I try to ask him to get me on the medical insurance he's currently taking? and if I should try to apply to medicare? Thanks

An EIN should be all you need, do not use your SSN on superbills. I think TIN is basically either your EIN or SSN, but not both.

If he sets your schedule, dictates how you are to practice, allows you to use office staff you are not really an IC. You should be classified as an employee. Otherwise you are getting hosed on taxes when that time comes (usually 40% too much in taxes--self employment taxes). You do get to deduct expenses but working corporate you have few deductions.

I saw another person say they keep 30% aside, and pay themselves 70%. I think this is a good rule of thumb.

I think the medical insurances are good ones to take if its possible to join them in your area. I personally do not take Medicare, because of the hassle of verifying deductibles (you can go to i believe checkmedicare.com and do it yourself for $0.25 to $0.50 per patient). Medicare can be pretty profitable, but I just choose not to accept it.

 

[KHE]

I think the medical insurances are good ones to take if its possible to join them in your area. I personally do not take Medicare, because of the hassle of verifying deductibles (you can go to i believe checkmedicare.com and do it yourself for $0.25 to $0.50 per patient). Medicare can be pretty profitable, but I just choose not to accept it.

Can you give an overview of the environment you are working in?

 

[Meibomian SxN]

Thank you for the advice. BTW, I graduated from UHCO and working in the Houston area. I applied for a EIN #, so do I still need a TIN #? I'm just confused. The doc I work for owns the lease to the office I work at, but I'm the only person seeing patients here. I'm being paid as a independent contractor even though I'm here every week. He does take some insurance such as BCBS, Aetna, but not medicare. Should I try to ask him to get me on the medical insurance he's currently taking? and if I should try to apply to medicare? Thanks

The EIN# is the same as the TIN#, the IRS uses the term TIN and everyone says EIN. Everything in America is confusing lol.

Regardless what insurances he takes, you can apply for your Medicare and other insurances while your there because you have a home office. If you ever decide to leave for another job you can take these prescious numbers with you and just change your address. Applying for these are tedious and take a while. There are also companies out there that will do it for you but they charge alot.

Good luck!