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MShore Law, Attorney
Category: Business Law
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Ifif I am an independent contractor healthcare provider in

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Ifif I am an independent contractor healthcare provider in working with a chiropractic business for example, and I am referred patients, do the patients (and patient files) "belong" to me or the business entity who is contracting me?
Thank you for the post, I am happy to assist you by answering your questions. The designation of whom own the patient charts should be specified per the independent contractor agreement entered into with the practice. However, if the contract is silent on this point, are the patients billed by the business or do you bill the patients directly?
Customer: replied 4 years ago.
There was an initial agreement made where i agreed to relinquish hold on the patients when I leave. However, uppn further research I found that this extent of control defines an employer emplyee situation. A independent contractor should be in posession of files and billing info by definition.
The agreement I signed, would make the relationship an employee relationship and make the contracting business liable for back taxes?
Thank you, XXXXX XXXXX is not necessarily true that in all instances an independent contractor is in possession of the patient files. To illustrate, an internal medicine practice can retain a dermatologist as an independent contractor and pay that specialist an hourly rate to see the practice's patients, the patients are billed by the practice and the charts remain with the practice unless and until the patients request that the charts be transferred to the independent contractor (which would be limited to the dermatology charts as the dermatologist would have no reason to hold the internal medicine charts). Another example of an independent contractor not holding patient charts is locum tenens work or moonlighting. To your question of back taxes, yes, if the practice is actually controlling the independent contractor such that it can be said that the independent contractor is an employee, then the practice would be liable for back employment taxes. Please let me know if this does not answer your questions or if you have any follow up questions.
Customer: replied 4 years ago.
I am an acupuncturist in an acupuncture office. I see some patients exclusively. My rates are determined by the office and are discounted compared to the general office rate. There are certain patients that I see exclusively by myself. The office does all the billing and my name is XXXXX XXXXX on billing forms even for my patients. I never realized this was a problem until now. With a number of patients I perform the totality of healthcare services in that business, not partially such as in your dermatology example. I feel I am treated, wrongfully, more like an employee due to the above reasons. Along with these issues that need to be addressed is the issue of who the patients belong to. Anything else you can say about this would be very helpful.
Thank you Mary, as the practice establishes the rate and bills under its name, even for your patients whom see you independent of the practice referring them to you, it can be said that you are an employee and not an independent contractor. this is particularly true if the practice does not have a separate billing/practice management service to cover billing. Please let me know if you have any follow up questions.
Customer: replied 4 years ago.
Thank you. No they do not bill for anyone they have not refered. But among those whom they refer many become my exclusive patients due to my discounted rate and other factors. Those patients are billed under the office account with a fee determined by the office and are invoiced for insurance by the office with the owners name not mine. Does what you said above still apply? Patients that are not referred by the practice that I see in the same workspace are billed and invoiced by me with a completely different fee schedule and are completely separate.
My question is just about my relationship with the main practice and the referred patients that I see exclusively who consider me their acupuncturist.
Thank you.
Thank you for the additional information, because there appears to be a separation between patients that you bill (your own patients) and the patients billed by the practice whom it contracts you to see, you can be deemed an independent contractor. Even though you see some practice patients exclusively, because the practice bills for your services under its name/provider ID those patient charts belong to the practice unless and until the patient directs otherwise.
Customer: replied 4 years ago.
My relationship to tje practice only exists insofar that I see the referred patients. The independent patients that I see on the premises are seen by a per room rental fee that is completely separate from the other relationship. My independent contractor relationship is only anout the referred patients. The other relationship I have with the practice is as a renter. The two are not combined. You are saying that even though the practice bills under its name for the referred patients and establishes my fee, the relationship is still that of independent contractor? Although the practice requires me to transition the patients to someone else if I leave, it is within the patient's rights to adk that their charts be transferred to me?
Yes, the relationship is still one of independent contractor. Please correct me if I misunderstand, but the practice does not dictate to you the course of treatment for the patients you see, whether practice patients or otherwise. The fact that the practice requires you to transition the patients to another provider does not mean you are an employee. It means the practice is shifting the care of its patients to another provider upon your departure. However, the patient always has the right to choose a provider and can require that the charts be transfered to you and you continue the treat the patient(s) in another location (assuming there is no noncompete/restrictive covenant that would restrict you from doing so). Also, does the practice provide you with paid time off, medical or life insurance? I ask because these are hallmarks of an employee relationship, and the absence of the same an indication of an independent contractor arrangement. Also, for your reference, here is a guide on differentiating between an independent contractor and employee.
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