Closing Down Your Chiropractic Practice – Do’s and Don’ts
I was recently asked what a doctor needs to do if he has decided to close down his practice. InTexas the Board of Chiropractic Examiners does not have a rule that outlines the requisite procedures that must be followed if a doctor wants to quit the practice of chiropractic. So we’ll look at what is generally required of a physician and assume that the same criteria would apply to a doctor of chiropractic.
You should give your employees suitable advance notice of your intent to close down. Next you need to notify your patients and/or their legal representatives of your intention. You should do this in writing. I recommend that you use certified mail with return receipt requested on your “high maintenance” patients, though it is not required and could be quite costly. Your letter should state that the practice is closing and that the patient will have to seek medical care from a different provider. Your letter should advise the patient that you will maintain their medical records for the next six years and should also include a medical record release authorization form for your patient to sign so that you can provide them with copies of their medical records as well as your permanent mailing address. With regard to your active patients you should also advise them that they can contact you to receive the name and location of other doctors who can continue their care and treatment. Always put a copy of your letter in your patients’ medical file.
If you are credentialed with any health care networks you should notify them of your intent to terminate your participating provided status and you should notify your licensing Board of the approximate date on which you intend to go inactive or cease seeing patients at your facility. If you do intend to continue to see an occasional patient you must maintain your chiropractic facility registration and your active licensure status.
It is important that you maintain control over your patient records in a safe and secure location that is both moisture proof and fireresistant. When your patient records exceed the state retention period they may be destroyed, with shredding being the preferred method.
Texas Board of Chiropractic Rule 80.3 details the fees that can be charged for copying of medical records. You must be aware that the Board’s rules will still govern your procedures even when you are shutting down your practice so be very conscious of turning over records within the 15 day regulatory time frame required Board Rule 80.3(c). Never provide original records to your patient.
A retiring provider will continue to be exposed to the risk of a malpractice allegation. Texas’ statute of limitations for the filing a lawsuit alleging professional liability is two (2) years from the date of the alleged act or from the date on which the claimant became aware of the act of negligence. You may cancel your professional liability insurance but you should take care to ensure that you have suitable “tail” coverage to protect against any such latent lawsuits.
Your billing and collection of accounts will continue for a number of months after your practice closes. While you may choose to outsource these billing/collection activities so as to not be burdened, however, if you do outsource your billing and collection activities you or someone close to you should maintain close oversight to ensure that proper efforts are being made to maximize the collectability of your aged accounts.
If you have any leased equipment you should review your lease contract and notify the vendor of your intent to close your practice so as to negotiate favorable terms for your remaining debt obligation. The same would apply to a landlord if you opt to cease operation prior to the expiration of an existing lease term. The closing of your practice may constitute a breach of your leasehold obligations so be sure to notify your landlord early on in your decision making process.