Prepared by: Carlos Arce, Esq.
Florida Healthcare Law Firm
If you seek to receive reimbursement by insurance payors in Florida, either through federal programs (Medicare, Medicaid, and Tricare), or commercial insurance (including Personal Injury Protection and Bodily Injury), you will either need a Health Care Clinic License or qualify as exempt under one of the exemptions. The process of getting a Health Care Clinic License is tedious but not impossible if you meet the requirements.
Initial Application
The initial application stage requires multiple forms to be completed by the person or entity attempting to apply for the license. You must also complete a proof of financial ability to operate form that must be completed by a licensed certified public accountant. Moreover, you and any other individual who plans on sharing in the ownership of the entity seeking licensure must be able to pass a level 2 background check. Last, each application requires a $2,000 license fee at the start. The initial stage is typically filled with confusion if you’ve never submitted this application to the Agency for Health Care Administration (AHCA) and had it approved.
Omission Letter
Every application submitted to the AHCA receives an omission letter as a response to the application. This is AHCA’s way of alerting you that they have reviewed your application, and they will point out issues they see with your application. If you fail to complete and respond to this omission letter within 21 days, you forfeit your application and will lose your initial $2,000 license fee.
Survey
Health Care Clinic License is based per location where you plan to operate the health care clinic. Therefore, each location where the services are to be rendered must be inspected by the AHCA’s auditing team. The survey requires that you have all the required posting at the clinic as well as the documentation that the state requires you to have on file surrounding your licensure, and your medical director’s inspection requirements. If you pass the inspection, you will be verbally alerted, and you should receive the license between 2-4 weeks following the survey.
Additional Steps
If you plan on billing personal injury protection benefits, you will require an accreditation by one of the four accrediting agencies in Florida. This will allow you to bill personal injury protection benefits right away. Florida law states that you must wait 3 years prior to billing personal injury protection benefits to a carrier unless you meet the accrediting agency requirement or one of the other exceptions under Florida law.
Attorney Carlos H. Arce works with the Florida Healthcare Law Firm in Delray Beach, FL. He has deep experience with health law, business law, and mergers & acquisitions. Carlos has handled multi-million-dollar healthcare transactions and has served as out-of-house counsel to various small to large healthcare entities. He can be reached via email at [email protected] or by calling 561-455-7700.