When selling a medical practice in Florida, you cannot simply transfer billing setup or insurance numbers to a buyer. Because medical billing profiles are tied to specific legal entities and credentials, transitions require a strategic approach to maintain cash flow.

Here are the key points simplified:

1. Navigating the "Billing Gap"

It typically takes 30 to 90+ days for insurance networks and government programs to approve a new owner's billing profile. To prevent revenue from freezing, transactions are structured using these strategies:

• Post-Closing Transition Agreements: The selling physician stays on as a temporary consultant or staff member. This allows the practice to continue billing under the seller's active credentials while the buyer waits for their own approvals.

• Accounts Receivable (A/R) Split: The seller usually retains ownership of collections for patient services completed prior to the closing date. The purchase contract must clearly define how old payments coming in post-sale are routed to the seller.

2. Government Payors (Medicare & Medicaid)

Federal and state rules strictly prohibit selling or renting Medicare provider numbers.

• 30-Day Advance Notice: A Change of Ownership (CHOW) must be submitted via the PECOS system at least 30 days before closing to update the business structure with Medicare.

• Asset Sale vs. Stock Sale Liability: In a standard asset sale, the buyer applies for a new agreement. If the buyer chooses to assume the seller's existing Medicare agreement instead, the buyer inherits all past historical Medicare audit liabilities and overpayment debts.

3. Commercial Insurance Networks

Commercial payors (like Florida Blue, Aetna, and United) process credentialing on their own timelines.

• Anti-Assignment Clauses: Existing commercial insurance contracts cannot be assigned or handed over to a new owner.

• New Credentialing Required: The buyer must fully credential their own entity and Tax ID with the networks. If the buyer is already an established provider in Florida, adding a new location is usually much faster than starting from scratch.

4. Florida-Specific Rules

Florida has unique regulatory oversight regarding who owns a clinic and how medical data is handled:

• The Health Care Clinic Act: If the buyer is an investor group or not a licensed medical doctor, the practice may need to register as a Health Care Clinic with the Florida Agency for Health Care Administration (AHCA) to bill legally.

• Patient Records Custodian: Under Florida Statute 456.057, the sale agreement must legally designate a custodian for historical patient charts, follow strict local newspaper publication rules for the public, and handle patient notifications properly.