MSO’s and DSO’s

Although most states do not allow non-dentists to own dental practices, they often allow companies to provide support services for dentists in exchange for a reasonable fee. To do so, many professions consider the formation of Dental Service Organizations (DSO’s) or Management Services Organizations (MSO’s). Although DSO’s and MSO’s can free dentists from the day-to-day distractions of tending to the business aspects of their practice, it is crucial to have a comprehensive agreement in place that specifically addresses an array of issues that may arise throughout the duration of maintaining these agreements. Working with a knowledgeable legal team can help to ensure you thoroughly understand your rights and responsibilities moving forward.

The attorneys at Leiva Law Firm have decades of experience representing professionals throughout Southern California with the formation and operation of MSO’s and DSO’s. Our team strives to establish management companies that comply with a variety of state regulations. We have helped some of the largest DSO’s to provide services to dentists across the country while staying well within the bounds of state laws that dictate the operations and the practice of dentistry. If you want to establish a DSO or MSO, or you are interested in legal options available to you, contact our law firm today to schedule a meeting with our skilled MSO and DSO attorneys in Los Angeles.

What are Dental Services Organizations (DSO) in California?

Dental Service Organizations or Management Service Organizations, DSO’s and MSO’s respectfully, are organizations that own the assets of a practice. These companies also provide some type of managerial services. Generally, DSO’s and MSO’s do not provide any care or control to patients and the treatment they receive. Instead, DSO’s will typically establish professional corporations that pay salaries to dentists. During formation, the corporation establishes service agreements with the DSO that owns a practice and collects its share of revenue.

Given the fact that state regulations prevent DSO’s from interfering with various activities, actions that are closely related to the professional practice of dentistry are only performed by dentists in the practice. With that being said, there are various ways that DSO’s and dentists split responsibilities.

Typically, dentists are responsible for various types of clinical activities including, but not limited to:

The process of hiring, training, and supervision other dental professionals
Hiring and firing dental processions
Evaluating, diagnosing, and treating patients
Keeping, accessing, and maintaining patient treatment records
Ensuring patients are provided quality services
Following clinical protocols

Aside from these activities, DSO’s often handle the bulk of aspects relative to general business practices. Some of the responsibilities of DSO’s include:

Marketing the clinic
Managing the information technology of the company and its IT infrastructure
Financial operations including payroll, tax preparations, billing, collections, and accounting
Office management tasks
Performing human resource management tasks with the exception of the hiring and firing of dental professionals
Risk management
Ensuring legal and regulatory compliance

It is important to note that states do not prevent dentists from assuming the responsibility for any administrative duty. However, doing so may be strictly prohibited under a specific DSO agreement. Working with a skilled and knowledgeable attorney can help to ensure you are aware of your rights and responsibilities moving forward.

Services Our Team Can Provide For You

Leiva Law Firm provides an array of services to ensure you are in the best position to move forward with the formation and operation of your DSO. Our team is well-versed on laws surrounding dental practice operations throughout the state of California. Our team is available to assist those who are subjected to illegal flee splitting and related regulations. Our team specializes in representing DSO’s across Southern California in the following areas:

Establishing and creating regulatory compliance business models
Conducting ongoing compliance of a wide-range of issues specific to the dental industry
Defending DSO’s in a variety of manners surrounding litigation and regulatory actions
Real estate acquisition for your practice
Private equity transactions
Ensuring labor and employment standards are met
Protecting intellectual property
Ensuring HIPAA compliance
Ensuring privacy concerns are addressed and met
Ensuring health care regulatory compliance
Assisting during government investigations
Expanding and creating DSO’s and MSO’s
Representing dental processional throughout California State Board Investigations Complaints as well as private legal proceedings with affiliated doctors and dentists
Assisting Private Equity Investors with the process of selling, buying, and investing in DSO’s

Regardless of whether you are a dentist who plans to retire but you have an interest in continuing to work on the business side of the practice or a non-dentist who wishes to be involved in the business side of dentistry, our team can provide services to you to complete the successful formation of an MSO or DSO. Our attorneys work diligently to ensure your MSO or DSO meets all state laws and regulations, provides your company with exceptional profit margins, and pays your dentists excellent compensation.

DSO and MSO Clients we Work With

When it comes to the formation of DSO’s and MSO’s our attorneys at Leiva Law Firm have a wealth of knowledge gained over decades of experience helping people from all walks of life come together to create and manage DSO’s and MSO’s. Some of the people we work with daily include:

Large Dental Service Organizations
Private equity investors
Other investors
Providers of mobile dental services
Dental practice management companies
Dental practices
Solo practitioners

We understand that there are often various parties interested in establishing, owning, and managing dental practices. We provide individualized representation for each client to ensure their unique desires are achieved so they are able to achieve their goals with the business.

What Does a DSO Agreement Contain?

One of the most challenging decisions that dentists have to make is whether they will create their own private practice or work with a Dental Service Organization. Working with a DSO comes with an array of benefits and drawbacks. Some of the benefits that come with DSO agreements include:

A more robust benefits package
Increased ability to focus on patients
Being able to enter the dental profession without having to overcome substantial financial barriers

Some of the main drawbacks of working with DSO’s include:

You will have less authority over personnel and the policies of the office
You will not have the freedom to choose a carrier for malpractice insurance
You are subjected to restrictive covenants

It is crucial that you understand what a DSO agreement is and what it contains before committing.

Establishing the level of authority: DSO agreements will specify who has control over which aspects of the business. Although private practices afford dentists authority over their team members, the software they use, and various processes implemented throughout their offices, these responsibilities are often shifted under a DSO agreement.

Compensation and Benefits: DSO’s may offer attractive opportunities for newly graduated dentists who are struggling with high levels of debt. DSO agreements will specify how dentists are compensated. Some agreements offer compensation that is provided strictly through salary. Others specify that dentists receive a portion of whatever payments are collected.

Professional Liability Insurance: Although most dentists prefer to maintain coverage from their own carriers, DSO’s often take responsibility over choosing what companies will insure their associates.

Termination of the agreement: Terms related to how a contract is terminated will be included within the agreement. This area will state the duration of the contract and what type of notice is required for termination.

Obtaining legal guidance from a responsive and knowledgeable legal team will ensure you are aware of what is included in your DSO agreement and what options are available to you.

Leiva Law Firm Is Here For You

Without a doubt, one of the fastest growing areas of the dental industry is the Dental Service Organization (DSO) market. This trend comes with no sign of slowing down. For this reason, it is crucial that anyone interested in the formation or operations of a DSO or MSO seek legal guidance as soon as possible. It is imperative that you are fully aware and understand the rights and responsibilities afforded to you as a business professional. Reaching out to a law firm that is knowledgeable of the divergent ways that dental boards view DSO’s will ensure you are in the best position possible moving forward.

The MSO and DSO attorneys at Leiva Law Firm have decades of experience helping clients throughout California when it comes to the creation and management of DSO’s and MSO’s. Our law firm has helped numerous DSO’s who provide services to dentists across the country while staying well within the bounds of state laws that control the operations and the practice of dentistry. Contact our law firm today at (818) 703-1777 to see how we can help you.