Q: I have been working in a group private practice as an independent contractor for past year. Because of numerous problems with the management, I am considering leaving and starting my own practice. I have a question that I can’t find the answer to…
I recently discovered that checks from one of the insurance companies with which I am credentialed has been sending my checks to the office where I work, made out to me, and only me, not me@practice name. Apparently, the management has been intercepting these checks and either cashing them or depositing them in the business’ account. Then, they have been writing me checks for (ALLEGEDLY) the percentage we agreed to in my contract, but they haven’t been providing the EOB’s for reference. Is ANY of this legal?
Sincerely,
Concerned Counselor
A: Dear Concerned Counselor,
I am sorry to hear that things are not working out with the group practice, where you are currently practicing.
About the matter with your checks, here is what’s probably going on. Even though the checks are coming in addressed to you, and you only, and you you@practice name, it is likely that the insurance company is still paying the practice’s tax ID number, not your social security number. This basically means, the practice will receive a 1099 at the end of the year for those monies, not you (i.e., they are paying the taxes on that money). Hence, as long as they are paying you your agreed share, everything should be kosher financially speaking. And legal.
About the EOBs, this was probably not an issue earlier in your relationship with the group practice–as you trusted they were paying you accurately. My guess is that as your relationship has deteriorated, you’ve become less trusting. I do think it’s reasonable to ask to see a copy of the EOBs. Alternatively, you might be able to call the insurance company and inquire as to what they have paid out. Or Thirdly, you could look at the insurance company’s reimbursement rates, and then do the math to determine if you have been getting a fair split (this last one will just be approximate, but at least you’ll know if your checks are within a reasonable range).
I hope this helps!
Sincerely,
Anthony Centore Ph.D.
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Anthony Centore
I’m confused by this answer. I’ve been doing research this evening on a similar issue, and it’s my understanding that the practice cannot bill the insurance company under their tax i.d. and still call this person an Independent Contractor. At least that is my interpretation. I’m including a link to one of the articles I came across in my research, and although in this case it was referring to Accupuncturists, the U.S. Tax code should be pretty consistent. I’ll be interested in your response, as I’m preparing to speak with an attorney about my own impending departure from a practice that has dealt with me in a less than honest manner. http://www.acupuncturetoday.com/archives2002/dec/12mcnamee.html
Hi Judy,
Thanks for reading, and for the comment! I myself am not a big fan of using independent contractors. I much prefer employees. Check out my article here: https://twx.atlantacounseling.com/blog/should-i-hire-counselors-as-independent-contractors-or-employees/
As the article from Acupunture states, “The IRS utilizes a 20-point test to help differentiate between the two.” While I respect Acupuncture Today, I respectfully disagree with the writer of the article you cited, as I don’t believe the items he listed necessarily differentiate independent contractors from employees. I hope this helps some, and I’m sorry to hear you’re had a bad experience with an employing practice.
Warmly, Anthony