This article applies in the case of the creation of a firm. In the case of a replacement or collaboration, some points will differ).
After the euphoria of obtaining the diploma, the stress of professional practice and the role of business manager (yes, business manager, that's right!) arrives. What steps should be taken? In which order ? What are the obligations ? etc.
Here are the broad outlines of what awaits you once you graduate!
1) Registration of the diploma at the ARS (Regional Health Agency)
This must be done in the exercise department. This registration will result in receipt by mail of the CPS (Professional Health Card) and its secret code (necessary for each connection of the teletransmission reader) and an ADELI number. The place of registration depends on the place and mode of exercise:
- liberal: registration in the professional department of the firm
- mixed (liberal + salaried): registration in the professional department of the liberal
- no employment: registration in the personal department of residence
For any change of department of practice, you must inform the ARS because it is impossible to register the diploma in two different places.
Registration must be done a maximum of one month after obtaining the diploma and it is not possible to register online.
You will therefore need to make an appointment and provide:
- the original diploma or provisional certificate
- ID card
- the CERFA registration form
2) Registration with the CPAM (Primary Health Insurance Fund)
This registration must be done in the exercise department. You will need to submit a file online and make an appointment with an advisor. The following parts will be required:
- the certificate of registration with the ARS
- a RIB (Bank Identity Statement)
3) Opening a bank account dedicated to the firm
It is not obligatory to open a so-called "professional" account but it is strongly recommended by bankers because of the number of movements on the account detected by the system. A professional account has advantages (dedicated banker, useful documents for accounting) but also disadvantages (higher price than a current account).
In all cases, it is preferable to have a credit card and a professional checkbook and avoid cash withdrawals (less justifiable in the event of a tax audit).
It is also a good idea to open a professional savings account to put money aside for paying social security contributions.
4) Registration with the CFE (Business Formalities Center)
You will need to go to the website www.cfe.urssaf.fr and register a request to start activity.
5) Registration with URSSAF
This will simply be a verification of the registration since the URSSAF will have been informed by the CFE of the start of activity. You will need to create a personal online space in order to pay contributions electronically (mandatory). This registration will allow you to receive a SIRET number representing the company.
6) Registration with CARPIMKO (Pension Fund)
Here again, CARPIMKO will have been notified by the CFE of the start of activity. You will also need to create your personal space to pay contributions and access deadlines.
7) Subscription to compulsory insurance
You will need to take out CPR (Professional Civil Liability) to cover possible accidents within the office.
In the event of animal mediation, this must be mentioned when subscribing so that the animal appears on the contract.
It will also be necessary to insure professional premises against damage (flood, fire, etc.) and theft.
Do not hesitate, even if it takes time, to ask for quotes and compare proposals.
8) Submission of the form to the CNIL
This institution provides protection in the event of theft or loss of the computer containing patient data.
9) Equipping management and teletransmission software
Several choices are possible but the features and prices are close. You have to choose one that you are comfortable with so as not to add stress to the start of your career.
Be wary of the first bill which will surely be very high due to the purchase of the vital card reader.
10) Membership of an AGA (Approved Management Association)
The latter is optional. However, it allows additional verification of documents before their transmission to the tax administration.
11) Choice of an accounting method
It is possible to hire a private accountant whose prices will vary depending on the services requested. You need to count on average at least 1500€/year.
The Indy accounting robot solution is also possible. How does it actually work?
Indy is linked to your bank account and automatically categorizes transactions so you don't have to. A simple check from time to time is necessary in case some transactions are not categorized in order to do it manually. Indy also prepares tax returns. Of course, you are not alone since a team of accountants is available and very responsive. Indy will only cost you €288/year (€24/month) but thanks to my sponsorship code, you will benefit from 3 months free!
12) Find out about possible assistance for business creation
- ACCRE: reserved for those under 26, it allows partial exemption from social contributions for the first years of activity
- ZRR aid: reserved for health professionals who settle in Rural Restructuring Zones, it allows total tax exemption for 5 years then decreasing over the following 3 years.
13) Presentation to surrounding colleagues
It is important to notify colleagues near the installation location of your arrival as waiting lists are generally in place. These colleagues will then be able to refer patients to you who will quickly fill your schedule. Do not hesitate to also indicate which pathologies you do not cover.