(Note: This guide updates over time as the boundary of knowledge and preferred systems change. Have additions? Connect with us at Info@EmbarkEMR.com)
Congratulations on embarking on your journey into the wonderful world of private practice. Understanding the landscape of what to do next can be difficult to understand and overcome. That is why we compiled this guide including our favorite, and most pragmatic, methods to establishing your private practice without excessive start-up costs. Nothing on this page constitutes legal advice, and the information is provided with the understanding that you will conduct your own necessary due diligence to determine what is the best fit for your practice. Some of the links on this page may contain affiliate links that help to support the maintenance and growth of this guide, as well as provide you a discount to utilize the service referenced.
- Establishing Your Practice’s Legal Status & Selecting the Best Operating Entity
- Picking a Domain & Setting Up a Website
- Setting Up Your Email & Business’s Digital Ecosystem
- Picking Your EMR (Electronic Medical Record) Software
Establishing Your Practice’s Legal Status & Selecting the Best Operating Entity
Types of business entities
- Sole Proprietorship: Simplest method of operating because they require almost nothing to start the business. You will still likely need to get an occupational license to operate; for the majority of readers who are professionals licensed by the state, this will be required no matter what business entity is chosen. A sole proprietorship exposes yourself to the greatest liability, as everything that goes on within the business is treated as if you were doing it personally. Meaning, if there were an incident to happen within the business, your personal assets are involved, and someone can sue for not only the money and assets of your business, but also personal money and assets (even if they have nothing to do with the business). Additionally, a spouse’s assets may also be at risk depending on the nature of the lawsuit.
- General Partnerships: Similar to a sole proprietorship, a general partnerships where 2 or more individuals decide they want to work together in some type of business arrangement (Short term or limited purpose projects are typically called joint ventures).
- Limited Partnerships:
- Sub S Corporation (S-Corp):
- Limited Liability Company (LLC):
- Limited Liability Partnerships (LLP): Offers both the advantages of a general partnership and the liability protection of a limited partnership. This would enable you to avoid personal liability for the actions of your partners, but you still have personal liability for your own negligence. To avoid this risk, form your own corporation to act as a general partner in the LLP.
- Professional Limited Liability Company (PLLC): NOTE: Not all states recognize a PLLC as a incorporated business structure. The PLLC is a variation on the regular LLC, which is a business structure offering personal asset protection for business owners in licensed occupations (E.G. healthcare, engineering). PLLCs are subject to the same laws as ordinary LLCs, but each licensing board must verify every owners professional license as well as approving the business’s articles of incorporation.
Forming Business Entity
The next step after you select your business’s name and what type of legal entity, you will want to file “Articles of Incorporation” and a “Business Entity Report” with your state’s secretary of state office. How to complete this process will vary state-to-state, but those are the next high level steps needed to occur.
Depending on your state, you may not even be required to form a formal business entity at all, but for most medical practitioners, you’ll want to form a formal business entity to shield owners from personal liability whenever possible. Note: you don’t even have to have a name yet to set up your business entity! You may want to start thinking about a name for when you start getting serious about branding and marketing (you can always update your name later!), but for now, JUST GET STARTED!
Cost: Varies by state (Certificate of Formation in Texas is ~$300, Articles of Incorporation for Indiana is $90) This is a set cost by your state, so there is no way to reduce the cost. Many attorneys and accountants will offer their services to set up the entity for you, but that cost can be an additional $200-$300 for something you can do yourself in 30 min to an hour. Keep those costs down! They add up quickly.
Obtaining Business Employer Identification Number (EIN)
Obtain a business Employer Identification Number (“business EIN”) number. You will need this number to open a business bank account, apply for business licenses, and file your tax returns… Keeping your business expenses separate from your personal expenses is crucial for record keeping. Head to the IRS website below to Apply for an EIN Online,
Setting up a Business Bank Account
Remember how we mentioned that it is crucial to keep your personal and professional expenses separate for record keeping and tax purposes in step 1? That’s why you open a business bank account! There are many recommendations for banks. One is to find a smaller, local bank that requires a low minimum balance to avoid frustrating fees for dipping below that minimum balance. Another is going with one of the larger banks that may have more available services, availability, and resources to invest in modern technology. A larger bank will likely have monthly fees to maintain the account, but you can often get around these by talking with the bank manager/business manager; just tell them you’re thinking of opening a business account with their bank, but are concerned about the extra fees, then ask if its possible for them to waive them. Always be prepared to walk away.
Cost: Free to open the account, but you’ll often need to make an “owner’s investment” of whatever the minimum balance is for the account you open (mine was $1,500)
Picking a Domain & Setting Up a Website
Setting up your website comes in a few different parts: first pick and purchase your website domain name. This is what people will type to find your page. Selecting a hosting provider can be a cumbersome and costly activity with so many options in this space. Lastly, build your site! (The fun part)
Choose and purchase your domain name
Most of the good domains have all been selected, but there are many creative ways to let your brand shine with a unique domain name. Domains ending in “.com” are still the gold standard when it comes to domains, as it is the default ending for most people when they think about websites. We’ve found searching for domains at Google Domains has been the best choice to find available domains with. It is simple and quick to use, provides related keyphrases for additional domains if your chosen domain is not available. This can be a creative and difficult process, but will pay off in the long run. It is best to also avoid posting available domain name choices on large social media groups that you don’t trust, it can be common for scalpers to monitor for these posts and purchase the domains before you and upcharge you. Most domains will cost about $13/year.
The next step, choosing your hosting provider, is where I would recommend you purchase the domain from. For example, if you select Bluehost as we recommend below, then purchase the new domain through Bluehost. It will be easier in the long run to manage your domain and website if the hosting company and domain registrar are within the same system. Originally, we registered domains within Google domains, but hosted on bluehost; this proved time consuming because of the need to occasionally update multiple systems as well as having multiple dependencies. Google wouldn’t help us because they weren’t bluehost, and bluehost wouldn’t help us because they didn’t have the domain. (Facepalm)
Choose your hosting provider
We’ve tested a LOT of platforms to build websites on, and ultimately decided to chose Bluehost as our preferred provider. Bluehost has excellent customer service, leverages the WordPress content management system (CMS) to build your websites, and has extraordinarily low rates along with a simple user interface. When we say low rates, you can host your website for as low as $2.99/month. There are currently 13 websites part of the Embark ecosystem, and we are able to host and manage everything for just $18/month.
Here is a referral link that will get you a discount on Bluehost and be able to host your own website for just $2.99/month,
Get a Logo
Getting a logo is not critical to running your business, but it truly can be a recognizable symbol for people to associate your brand with. Creating a logo is not too difficult either. To get a logo for free, you can throw some shapes together with your business name in PowerPoint (or utilize PowerPoint’s “Design Ideas” section – I love this!) and BAM! You have a logo. If you’re not a creative type or would prefer to have a professional looking logo, I recommend the folks over at Fiverr. Fiverr is a platform where you can outsource almost any task to a global workforce of skilled specialists to complete it for you. Often times, you can have highly professional and qualified people design a logo for you for <$55. To get started with Fiverr, just head to Fiverr.com. As an added bonus, you can get 10% off your first order by using the link http://www.fiverr.com/s2/5090546013
Build your site
Bluehost has WordPress setup out-of-the-box, and WordPress is an easy-to-use page builder. There are other builders as well. Our preference, in terms of ease of editing and speed, is to use Elementor. Install “Elementor” as a plugin, and then utilize “Hello Elementor” as your Theme. Another option is to stick with the WordPress basic page builder. If you choose to do this, we’ve had a lot of success using the “Sinatra” theme. It has a lot of features, and is super easy to utilize. If you’re not familiar with WordPress, it boasts a very simple “Drag-and-Drop” interface and there are TONS of YouTube videos out there to help you out.
Looking for design inspiration? Steal shamelessly! Browse other websites, including sites of other business’s like yours and not. Take notes on what you like and steal bits and pieces from across the web. A great resource to designing a great website is to look at the book Building a Story Brand by Donald Miller. While not a book on webdesign, it contains outstanding information and resources on how to engage with your customers (and chapter 12 is all about “Building a Better Website”)
Key things to keep in mind when designing your website are, (As adapted from Building a Story Brand by Donald Miller)
- Have an offer above the fold: The term “Above the Fold” comes from the newspaper industry referring to the stories above the fold of the newspaper. This is what your users will see first, so be sure to include a call-to-action button and an offer in the top of your website that can be seen before the user scrolls.
- Obvious Calls to Action: A call to action is where you’re asking your user to take action (like soliciting your services). These calls to actions should be obvious, a button in a bright color that stands out from everything else on the page. The whole point of your website is to have a place where your potential client can determine if your services are a fit to their problem and take that next step for you to begin offering services. Put it in a place where the button makes sense and is enticing.
- Images of Success: How might you illicit an emotional response and make your potential client feel the emotional reaction you’re trying to convey, but have them feel it through your website? How about by displaying pictures of smiling happy people? Instead of just showing pictures of your product, how about placing your product in the hands of someone smiling?
- A bite-sized breakdown of your revenue stream: How do people pay you? How much will it cost them? You don’t need to display exact figures, but you want to communicate to your audience your service is worth their investment. Maybe state “X% of people have their services covered by insurance”
- Very Few Words: People don’t read websites anymore, they scan the content. If there is a paragraph on your site, it’s likely being passed over. As customers scroll down through your page, it’s ok to use more words, but keep it short. Think about how you can simply your message to a few bullet points connected with pictures of happy people.
Setting Up Your Email & Business’s Digital Ecosystem
If you plan to be communicating with your clients via email, you will need an encrypted email. If you don’t plan to transfer any protected personal health information, getting a Google Workspace account is an excellent choice! You get access to Google’s breadth of services like Sheets, Slides, Google Meet, Jamboard, Gmail, and more. You can purchase the “Business Starter” plan for just $6/month. To make your account HIPAA compliant, follow the below instructions on how to get a BAA with Google (Note: a free Gmail account is not HIPAA compliant.
Steps to reviewing and accepting Google’s Business Associate Amendment,
- In your Google Admin console (at admin.google.com)…
- Go to Account settings > Legal and Compliance.
- In Security and Privacy Additional Terms, under Google Workspace/Cloud Identity HIPAA Business Associate Amendment, click Review and Accept.
- Answer all three questions to confirm that are a HIPAA covered entity.
- To accept the HIPAA BAA, click OK .
Getting Your Google Workspace Account (And Applying a Discount!)
Click here to get your Google Workspace account. Additionally, here are two promo codes to get you 10% off your first year!
- Google Workspace Business Starter Plan: KAXEDPHDTQMJ4UW
- Google Workspace Business Standard Plan: K43MEPHD4THGW3A
Each promotion code provides 10% off the first year on either Google Workspace Business Starter plan or Google Workspace Business Standard plan*
Picking Your EMR (Electronic Medical Record) Software
An EMR can be immensely valuable in maintaining HIPAA compliant records within your practice, as well as accelerating the time required to complete notes, schedule appointments, and many other time consuming tasks. As a start-up practice, a great way to do many basic tasks is to build yourself a system within Google Workspace. With a combination of Sheets, Forms, and Drive, you might even be able to create your own EMR to get you by!
When starting SpeakIndy as a new practice, this is the path the owners decided to go. It worked well, but required quite a bit of maintenance and support, didn’t reduce the time required to complete the necessary tasks, and its automation capabilities were fairly limited. Once SpeakIndy began leveraging a purpose built EMR, specifically intended for therapists and counselors, the amount of benefits and time savings were enumerable; especially as their practice grew. If they could start over, signing up with an EMR (and better managing their costs) would be the #1 (& #2) thing they would do.
There are a few key factors in choosing an EMR for your practice.
- Features: Ask yourself, what “job(s)” are you hiring an EMR to do for you? Common features include: scheduling, appointment reminders, note templates for each of the various types of documents required (Session notes, Progress Notes, Discharge Notes, Evaluations, Plan of Care, invoicing, superbill generation, patient portal, goal performance analytics, and more). A small private pay practice will have the least amount of requirements for an EMR, and this is where Embark EMR shines. Not only is Embark a great choice for large practices, but is a perfect choice for small private pay clinics.
- Support & Flexibility: You will undoubtedly have questions about the EMR and how to use it, but you may also have ideas of improvements or subtle changes that might make things even easier for your practice. How receptive is the EMR company to feedback and implementing new user-centric ideas?
- Cost: Managing your cost from day 1 is one of the most important things your can do for any new business. As you grow, these costs often grow with you. When choosing an EMR, cost is a major factor that can quickly escalate and get out of control. Many companies boast a “low” rate, like $59/month per provider, but then add on an extra $1 for invoicing, $5 for storage, $10 for appointment reminders. What was once a low rate, may become >$100/month to make the system meet your needs. As you add on future providers, this cost multiplies with not only another user, but there may also be “group practice surcharges”.
For example, a popular EMR advertises $59/month per provider. You select their lowest tiered plan to start, adding on document storage and appointment reminders, you end up paying $83/month (Average taken from many users). Your practice has now grown to 5 providers, each requiring a license, making the total cost $470 per month after the additional $55 group surcharge. That’s $5,640 per year for what was advertised as a low cost system.
By comparison, Embark EMR offers a truly low rate at just $20/month per provider with no extra fees. The only add-on you have is for unlimited document storage for an additional $10, making your total $30/month. Now that your practice has grown to 5 members, your EMR cost becomes $150 per month or $1,800 per year. That’s $3,840 per year saved for just a 5-provider practice! Imagine the savings for larger practices… To get started with or learn more about Embark EMR, head to www.EmbarkEMR.com and begin your free 14-day trial.