Forging Ahead–A Private Practice Checklist

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(This post originally appeared on Activity Tailor)

Hooray! You’ve decided to take the plunge and start working for yourself. Now it’s time for some organization:

  1. Proper mind set: Grab a glass of wine or a cup of tea. Dream! What do you want out of this venture right now? What do you want in 10 years? Having some sort of framework for your business will help you make a lot of the decisions that lie ahead. Hey while you’re at it—write those dreams down!
  2. State license: I’m assuming your CCCs are all in order, but depending on your state and/or previous place of employment you may not be licensed by your state speech-language-hearing board. A quick phone call can save you future heartache. Most state boards will simply require proof of your degree, ASHA certification and yearly dues, but it may take some processing time. Also, be sure to find out if there are different ceu requirements. In my state, I was able to file a petition so my state and national continuing ed intervals ran concurrently.
  3. Pick an Entity: This is a fancy name for deciding how your business will be set up. You may choose to have your business income show directly on your personal income tax (sole proprietor) or establish a LLC and have the business as a completely separate enterprise. This is something to discuss with your accountant to determine the best decision for you. Invest in advice!
  4. City license/permit: I filed my “dba” (doing business as) name at the register of deeds and then applied for a city business license. Each year I’m required to calculate my gross income from services and/or goods and pay fees to the city. A dba might be “Kim Lewis, M.Ed. CCC-SLP” or “Activity Tailor”. Consider your decision. Your personal name might be very recognizable, but will it limit you if you hope to add clinicians or goods one day? Should you check if it’s an available domain name?
  5. Business banking account: You’ll want to keep your business transactions (income and payments) separate from your personal accounts. In all likelihood a checking account will suffice. However, if budgeting is not a strong suit you may want a savings account attached as well. Remember, you’ll be responsible for all your taxes at the end of the year. Transfer the estimated amount (based on that month’s earnings) on a monthly or quarterly basis if you think this will be a problem otherwise.
  6. Employer Identification Number (EIN): You or your accountant will need to apply for this with the IRS even if you are your sole employee.
  7. Malpractice insurance: You may already have this even if your employer provided some, but now that you work on your own, make sure you are covered. ASHA provides discounted rates that are very reasonable.
  8. Pricing research: Call around to some local practices and get information on pricing for both evaluations and therapy. Make sure you establish a rate that’s commensurate—don’t try to undercut the market; we all pay for that! Work out a fee schedule for various evaluations (i.e. screening vs. full eval) and therapy sessions (i.e. 30 or 45 min).
  9. Determine your wage: Be disciplined and set yourself an hourly wage. Just remember, in private practice you are only paid for patient contact hours. ***when I began to explain this item in detail, it became too huge to include here. I will post this separately in the next couple of days.
  10. Create forms and policies: OK, this is the part I dislike most, but it still needs to be dealt with—the paperwork. (*** Again, this is a line item in which the explanation went out of control. I’ll list what you need here, but will post in more detail within the week.) You will need at least the following: fee schedule, billing policy, cancellation policy, privacy policies, case history, insurance claim forms, treatment notes, monthly progress notes, evaluation summary form.
  11. Marketing Materials: At a minimum, you’ll need a business card with your contact info and perhaps space for noting appointment times, but you might also consider envelopes, letterhead or a marketing brochure. A local print shop can assist with a logo. ASHA.org has predesigned stationary that you add your info to for a reasonable price.
  12. Therapy/Evaluation Materials: This can quickly become an expensive endeavor. Tests and their forms can be quite pricey (anyone with great ideas for scoring bargains—let us know!) I would suggest purchasing the 2-3 you’ll need most frequently and adding as you see fit. Therapy materials are usually more economical and, again, you can add as you go.
  13. Make a Plan: Brainstorm some ideas for finding clients. This might include contacting local schools, pediatrician’s/doctor’s offices, or local social agencies. An ad in a local magazine might be helpful. Offer to give an educational talk at a mom’s group or senior center.
  14. Find Support: You’ll have some exciting and scary days ahead. Share it! Another private therapist willing to mentor you would be fabulous, but don’t underestimate an encouraging friend. For me, a positive attitude with limited knowledge would help me more that an experienced, but dour, practitioner.

Ask questions and good luck!

 

Kim Lewis M.Ed, CCC-SLP has a private practice for pediatrics in Greensboro, NC. She is the blogger at www.activitytailor.com, providing creative ideas for speech therapy, and the author of the Artic Attack workbook series.

Comments

  1. There are many more issues and avenues for private practice but this list is a great start!
    Fully investigate this option and ensure a high level of professionalism at all times!
    Enjoy the journey……

  2. hi. did you write your other blog about determining your wage and the forms and policies??? do you have any samples of these that you could share? Also, is a city license/permit the same thing as your LLC??? Thanks!

  3. I did write the other posts. You can find the one on wages at: http://www.activitytailor.com/blog/?p=26 and the one on forms at: http://www.activitytailor.com/blog/?p=35. Let me know if you need more than that. The LLC is very different from the city license/permit. An LLC is the way your business is set up for tax purposes (I’d really recommend talking to an accountant). A city license/permit involves a fee and city taxes, but is like a permission slip to do business in your area. Clear as mud? Once you get into it, it really isn’t so bad!

  4. Do I need a physician order for a private pay patient

    • Denise, This is not an area I feel comfortable giving you counsel on because I have a hunch it depends greatly on the circumstance. I work with pediatrics, primarily in educational settings, and I do not need a physician’s order. If I were contracting in a medical based setting or working with feeding or dysphagia, I think I would insist on it.