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MShore
MShore, Attorney
Category: Legal
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Experience:  Negotiate, Draft, and Review many complex commercial agreements each year.
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can an optometrist bill in NY under an LLC owned by a non professional

Resolved Question:

can an optometrist bill in NY under an LLC owned by a non professional or does the LLC require professional ownership? and if so, does it need a PLLC?
Submitted: 1 year ago.
Category: Legal
Expert:  MShore replied 1 year ago.
Thank you for the post, I am happy to assist you by answering your questions. The LLC requires professional (licensed person authorized by the State to practice medicine) ownership unless it is a non-profit. Only a person licensed or otherwise authorized under this
article shall practice medicine. See N.Y. Educ. Law § 6522
(2006). A non-profit medical corporation or a hospital service corporation may employ licensed physicians, but a private practice must be owned by licensed providers. See N.Y. Educ. Law § 6527 (2006) Also, see People v. John H. Woodbury Dermatological Inst., 85 N.E. 697 (N.Y. 1908).

A professional service limited liability company may be formed by filing Articles of Organization pursuant to Section 1203 of the New York State Limited Liability Company Law. Also, see http://www.op.nysed.gov/prof/med/


Please let me know if you have any follow up questions.
Customer: replied 1 year ago.
I have a friend that has over 20 optical stores that employ optometrists (not ophtholmalegists) and he bills the insurance under a corp that's owned by him (non professional). how is it possible?
Expert:  MShore replied 1 year ago.
Do the optometrists bill the insurance companies the professional component? I ask because it is a common arrangement to treat professionals/licensees as independent contractors such that they are not employees of the business, and the business bills as a practice management suite, but does not actually bill under its own provider Id (as it does not have a provider ID) but bills under the provider's ID, and retains a portion of the revenue generated as payment for the billing service and practice management. For your reference, see also http://www.op.nysed.gov/prof/med/
Customer: replied 1 year ago.

They bill it under a professional component. He told me that in NY it's legal, but i guess you're the expert.

Expert:  MShore replied 1 year ago.
The business could bill the professional component, but under the provider's name, not its own name. Essentially the business could act as a practice management suite for each provider and pay the practice overhead, retain a portion of the practice revenue for itself, then pay the remainder to the provider.
Customer: replied 1 year ago.
Does That mean the professional does not have to be an owner of the corp?
Expert:  MShore replied 1 year ago.
No, it means that the professional and the corp would actually be two separate entities, the corp handles the billing and management of the professional's practice, in exchange for a portion of the professional's revenue.
Customer: replied 1 year ago.

But to which account does the money from the insurance get deposited to, the one connected to the corp, or the optometrist's?

Expert:  MShore replied 1 year ago.
The optometrist, which is managed by the corp. Bear in mind that this is just one "work around" that is commonly employed. Your friend may utilize another, but again, NY does not permit a corp to employ licensed providers unless all shareholders in the corp are licensed providers as well. (there are certain exceptions, such as for hospitals, non-profits, or HMOs but your friend's business does not seem to qualify)
Customer: replied 1 year ago.

does the optometrist need a PC or does a basic corp suffice? last question ;)

Expert:  MShore replied 1 year ago.
The optometrist would need a PC or PLLC as he/she is engaged in a professional activity.
MShore, Attorney
Category: Legal
Satisfied Customers: 25285
Experience: Negotiate, Draft, and Review many complex commercial agreements each year.
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