Title Page

  • Facility Name

  • Conducted on

  • Prepared by

  • Location

Closure Checklist

Notifications - 60 to 90 days before closing

  • Staff

  • Organize a staff meeting to notify employees of practice closure

  • Prepare to hire temporary staff if current employees leave prior to closing date

  • Patients

  • Prepare and send notification to patients listing the closing date and reason for closing

  • Include an authorization form to transfer medical records to your patients’ new providers

  • Place a dated copy of the notification in each patient’s medical record

  • Public

  • Publish local newspaper ads with details about the closing

  • Post signage in your office to notify visitors of your last day of business

  • Professional Associations

  • Notify the state medical board, licensing board, credentialing organizations, professional memberships, etc

  • Drug Enforcement Agency (DEA)

  • Inform the DEA of your wishes to either continue or surrender your DEA registration

  • Health Insurance Companies

  • Inform all contracted payers of your intent to close your practice

  • Provide payers with a forwarding address to send payments that resolve after the office closes

  • Hospitals

  • Notify the hospitals where you have privileges of your intention to close your practice

  • Ancillary Services

  • Contact ancillary services such as labs, MRI facilities, etc. that you refer patients to

  • Suppliers/Service Contracts

  • Inform medical suppliers, office suppliers, collection agencies, laundry services, housekeeping services, hazardous waste disposal services, magazine subscriptions, etc.

  • Request final statements from these vendors to close your accounts with them.

  • Other Physicians

  • Let the colleagues that you work with, or refer to, know of your decision to close

  • Utilities

  • Notify all utility service providers of the day you wish to discontinue service

Tasks - 30 to 60 days before closing

  • Patient Scheduling

  • No new patients should be accepted once the closing date is announced

  • Start restricting nonemergent appointments as much as possible

  • Patients who need continual follow-up and care should be referred to another provider

  • Accounts Receivable

  • Process your accounts receivable, as much as possible, to collect money owed to you

  • Consider employing a collection agency or staff member to reconcile accounts after the practice has closed

  • Insurance Policies

  • Review your and your employees’ insurance policies and update or cancel where appropriate: i.e., liability, health, life, disability, workers compensation, etc

  • Obtain tail coverage extended liability insurance if necessary, which provides coverage against claims reported after the liability policy expires

  • Medical Records

  • Arrange for safe storage for both paper and electronic medical records

  • Notify your state medical board of the storage location

  • Determine the correct amount of time your medical records should be stored, as defined by your state law

  • Make sure the storage facility has experience handling confidential patient information and HIPAA agreements

  • Establish a mailing address or PO Box for medical record requests after closing

  • Clinic Documents & Equipment

  • Arrange for storage of personnel records according to your state law

  • Organize the disposal or proper storage of clinic documents such as financial records, patient education materials, brochures, etc

  • Plan to sell or lease office and medical equipment, if appropriate

  • Medications

  • Follow the federal guidelines for disposing of prescription drugs and medications

  • Contact drug representatives to determine what to do with unused samples, if applicable

  • Destroy all prescription pads

  • Phone Service

  • Consider using an answering service or prepare messaging for office phone calls after the closing date

  • Mail Service

  • Contact the postal service to coordinate mail forwarding details

Completion

  • Comments/Recommendations

  • Name and Signature

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