Written by attorney John C Peick

Washington: Starting Your Own Healthcare Business Part 2

3.Regulatory Environment

As a business in the State of Washington, there are numerous city or county, state and federal agencies with which you must register. All of these agencies have internet sites that provide information and necessary forms. Below are samples of what you can expect:

  • Internal Revenue Service You will need to acquire IRS Form SS-4 so you can make application for your Federal Employer ID Number (Income tax, FICA, Withholding & FUTA). You are responsible for completing and filing this form. If you choose to become a Subchapter S corporation, then you need to obtain, complete and file IRS Form 2553 within 75 days of starting business or incorporation. In Washington, a community property state, both husband and wife must to sign the election form.
  • Wash. Dept. of Revenue A Master Business Application (MBA) must be completed and submitted to the State of Washington to obtain a Uniform Business Identification number (UBI). DO NOT file the MBA if you are incorporating a PS or PLLC, because the UBI will be provided with the return copy of your filed Articles of Incorporation or Certificate of PLLC. If you file both at the same time, the State will assign a second UBI number and you will spend considerable time sorting out the confusion. Once registered, the state will then send you information on state taxes, including excise and Business and Occupation taxes.
  • Wash. Dept. Labor & Industries (DOLI) Filing the MBA will satisfy the filing with DOLI. State industrial insurance covers employees who are injured on the job. The cost is a percentage of their monthly gross salary. Owners or corporate officers may also have coverage or can opt out. You must make the election to cover owners or corporate officers and notify them (even notifying yourself in writing) if they are not covered.
  • Wash. Dept. Employment Security (WDES) Filing the MBA will handle registration with WDES. If you have employees they must be covered by unemployment insurance. For corporate officers this coverage is optional. The charge to you for this increased coverage varies.
  • Business Licenses Filing the MBA does NOT satisfy city or country business license requirements. Some cities and counties vary on the requirement for business licenses and subsequent payment of city B & O tax. You must contact your city licensing agency.
  • Professional Licenses As a licensed health care professional, you are solely responsible for procuring your own license from the appropriate Department of Health agency.
  • Participation Agreements Certain health care organizations, health plans, the state Department of Social and Health Services and Department of Labor & Industries require independent approval or credentialing of your participation in their health care program. Please make sure that you can transfer these participation credentials [e.g. PPO, MCO, CMS and DOLI practitioner contracts or numbers] to your new corporation, or alert those who reimburse you for care to issue checks to the new organization.
  • Zoning Cities and counties have zoning restrictions upon businesses locations in residential areas. Normally, there are exceptions allowed for "paper" businesses in which the residence is merely a mail stop or records storage location. Know your local requirements before you establish a practice open to the public.

4.Bank Accounts

Having a good working relationship with your banker is critical as your business grows and your credit needs expand. Do not operate your business out of your personal account. In the beginning, open up a business account, use a check ledger and business checks. If you are going to use any billing and accounting software, purchase the type of checks you can use with a printer. You should also apply for a merchant account so you can accept credit cards.

5.Business and professional insurance

You will need errors and omissions coverage for any professional liability arising from the operation of your clinic, and from treating patients. In addition, you will need premises insurance to cover yourself if someone is injured while in the clinic, or on your premises. If you are subleasing, insure your landlord has such insurance and that you are also covered. Otherwise, you need to get your own insurance. You will also need to get coverage for fire or casualty loss of any equipment, furniture or fixtures/tenant improvements.


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