Business/Tax structures
Several options exist for interventional cardiologists starting to practice. It is important to carefully investigate which business structure works best for you. Consult with an attorney to determine which business structure is best for you.
Establishing a Private Practice
A physician practice can be established as a sole proprietorship, partnership, corporation, S corporation, or limited liability company. The Small Business Administration provides a good overview of these structures. The IRS provides information about the forms needed for each type of business structure.
Tax ID
Once the decision is made about business structure, you may need to apply for a tax identification number from the IRS.
Joining an Existing Group
When joining an existing private practice group, the business structure will already be established. Initial contracts may be for an employed relationship with options to become a partner at a later date. Private practices may also have ownership arrangements with Ambulatory Surgery Centers (ASCs).
Signing an Employment Contract with a Hospital
While this option has the fewest steps to start practicing, it is important to fully understand the terms of the contract. Some contracts pay salary and/or bonuses based on RVUs. Understanding the expectation of number and type of cases per day will help to inform the employment decision. Also, carefully reviewing stipulations like noncompete clauses will also help to manage expectations.
Regardless of the business structure you choose, you will need to obtain a national provider identification number and a DEA number.
National Provider Identification Number (NPI)
An NPI number is a unique identifier that was established under the Health Insurance Portability and Accountability Act (HIPAA) for healthcare providers to use for multiple purposes, namely contracting with different insurance companies. You can apply for an NPI number after creating an account with NPPES.
DEA Number
In order to write prescriptions, you must register with the Drug Enforcement Administration. This may have been completed for you during your residency program. If so, be sure to update your contact information and watch for renewal notices.
Informed Consent
Informed consent occurs when a physician educates a patient about a procedure, including the nature of the procedure along with the expected benefits and risks. The patient should sign an informed consent form giving their permission to proceed. The physician must ensure that the patient is competent to make the decision on their own behalf and address the patient’s surrogate where competency does not exist.
Informed consent for clinical trials and other research purposes has additional guidelines.
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Neither SCAI nor its employees or representatives are qualified to make clinical judgments or to render legal advice and counsel regarding the proper code for any given procedure, nor the consequences of use of any code including use of codes for purposes of reimbursement. For legal advice, recipients of such information should consult their own counsel.
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