Originally presented in webinar format by David Bibbey, LAc. The webinar is available to all FSOMA members here. Log into your membership account to gain access.

Business Basics: Opening Your First Acupuncture Clinic

Congratulations on completing your academic journey in acupuncture! Now, it's time to turn your knowledge into a thriving practice. This article provides a comprehensive guide to help you navigate the crucial steps involved in opening your first acupuncture clinic.

Licensure Requirements

Before you can begin your acupuncture career, it's essential to meet the licensure requirements in your state. In Florida, these requirements are outlined in Chapter 457 and the Florida Administrative Code rule, under 64B1. To obtain your license, ensure you meet the following:

• Age Requirement: Be at least 21 years old.

• Application Fee: Pay the application fee (currently $405).

• Training: Complete your entry-level training program.

• Examinations: Pass the NCCAOM national exams.

• English Proficiency: Provide proof of English proficiency.

• Insurance: Secure professional liability coverage. You'll need this insurance before applying for your license.

Maintaining Professional Membership

Maintaining your professional membership with FSOMA will help you stay updated on industry developments, advocacy efforts, and essential information pertinent to your professional career. 

Establishing Your Business Entity

Decide on the legal structure for your clinic, taking into account tax responsibilities and liability concerns. Options include Sole Proprietorship, Limited Liability Corporation (LLC), Professional Association (PA), or an S-Corporation. Consult with an accountant to determine the best fit for your situation.

Office Space

When considering your clinic's location, you'll have three main options:

• Leasing: You are responsible for base rent and potentially CAM fees (community fees, trash, maintenance, property taxes, and insurance). There is no equity involved.

• Renting: Similar to leasing but may include or exclude CAM fees and utilities. No equity is built.

• Buying: You are responsible for the mortgage, taxes, insurance, maintenance, and utilities. This option allows you to build equity.

General Liability Insurance

Understand your insurance coverage, whether provided through your lease or rental agreement or independently. Typical commercial general liability coverage includes various limits for different aspects, such as general aggregate, products and completed operations, personal and advertising injury, and more. Make sure to contact your Insurance Broker to discuss appropriate limits. As a FSOMA Member, you receive exclusive member discounts with Schlitt Services.

Example - A Typical Commercial General Liability:

Business Tax Application and Licensing

Ensure compliance with local business tax requirements, including obtaining a local business license, providing documentation, and paying necessary fees.

REQUIREMENTS:

• Copy of SunBiz Business Registration

• Copy of State Issued License DOH 

• Estimated Fee of: $50 - $100 

• May also require copy of General Liability 

• May also require a copy of your Lease/ Rental Agreement 

• Copy of Fire Exit/ Plan Drawing

Important Notes for an Acupuncturist’s Office:

• No need for an Establishment License 

• No need for hand-sink in the treatment room

• No National Electrical Code (NEC) (may change over time)

• AHCA Health Care Clinic Exemption (Section 400.9905 (4) (g) FS  (Estimated cost is about $100, and is issued every two years)

• ADA Accessibility (width of your doorways, width of hallways, access to your front desk, handicap accessibility built into your public restrooms, in general meeting the accessibility requirements.)

Clinic Manuals in Employee Handbook

Document clinic policies and procedures in your Employee Handbook to ensure easy accessibility in case of unforeseen events or incidents. This includes: 

• Document policies and procedures that govern clinic’s administrative practices.

• Employment Basics. 

• Workplace Policies. 

• Code of Conduct. 

• Compensation and Development. 

• Benefits and Perks.

• Working Hours, PTO, and Vacation.

• Employee Resignation/ Termination.

• HIPAA Privacy and Security Handbook. 

Important Note: HIPAA privacy rule requires that healthcare providers develop and distribute a notice that provides a clear, user-friendly explanation of individuals' rights with respect to their personal health information, and the privacy practices of your office.

• Document Policies 

• Workforce Training 

• Privacy Officer

• Security Rule

• Security Risk Assessment (SRA)

• Employee Sanction Policy 

• EHR/EMR

• Data Access Policies

• Breach Notification Plan 

• Complaints/ Concern Policy

Work Safety and Regulatory Compliance

Familiarize yourself with safety regulations, biomedical waste management, infectious disease plans, and ADA accessibility requirements for your clinic.

FSOMA Members can download a Biohazard Waste Disposal Manual to add to their Red Book. (Log into your membership account or email us at [email protected] to gain access).

A Red Book contains all your work safety and regulatory compliance documents and manuals. Consider including:

• 94E.16 Biomedical Waste

• Biohazard Waste Disposal Manual

• Infectious Disease Plan, Training

• OSHA Hazard Communication Plan 

• Safety Data Sheet 

Retail of Dietary Supplements and Herbs

If your clinic sells or provides these products to patients, be aware of the regulations and permits required for their sale, including food permits and Hemp Food Establishment Permits for CBD products.

Florida Department of Agriculture regulates retail sales of food, herbs, supplements, and CBD products under Florida Statute F.S. 500.12

Food permits:

• Food permit from the Florida Department of Agriculture is required of any person who operates a food establishment or retail store

• Exemptions: An establishment operating minor food outlets that sell items that are commercially prepackaged, not potentially hazardous, are not time or temperature-controlled for safety, and if the shelf space for those items does not exceed 12 total linear feet and no other food is sold by the minor food outlet.

Retail CBD Sales in Florida

• Licensing is required for those who wish to grow and sell hemp products.

• Processing, manufacturing, distributing, and retailing of ingestible and inhalable CBD products all require a Hemp Food Establishment Permit. 

• Permit fee is $650 annually.

Insurance Credentialing

Complete a CAQH profile to streamline the credentialing process with insurance companies, ensuring smooth interactions and reimbursements.

Credentialing with Healthcare Networks

If you plan to work with healthcare networks like the VA Community Care Network, Optumhealth, or United Healthcare, you'll typically need a professional liability insurance plan with coverage ranging from 1 million to 3 million dollars.

Vendor Relationships

Establish relationships with vendors and suppliers, including liability insurance providers, compliance companies, property management, utilities, cyber-security, and more, to support your clinic's needs.

Bookkeeping vs. Accounting

Understand the distinction between bookkeeping, which helps you manage finances and expenses, and accounting, which focuses on tax strategies and financial optimization. You will need the support of both these experts.

Financial Planner and Attorney

Seek guidance from financial and retirement planners to secure your financial future and consult with attorneys to address legal concerns, entity formation, and risk management in your practice.

As a FSOMA Member you receive a free 15 minute consultation and discount in retainer fees on Business Law and Healthcare Law.  

Establish a Disclosure Notice and Financial Policy:

A payment policy lets your patients know what you expect of them and what they can expect of you . A well-crafted policy will prevent them from being surprised about their financial obligation when they receive your services. It will also give your practice some legal protection should a patient fail to pay what you are entitled to collect. 

By following these steps, you'll be better prepared to navigate the complexities of opening your first acupuncture clinic and building a successful career in the field. Again, congratulations on your new professional career.