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The other day a client came to me who has his own dental clinic. He had no idea how to attract customers, scale his business and make big profits. It’s easy to increase dental profits by using a few tips from this article. Read on.

Today I will tell you about the difficulties that “young” dental entrepreneurs face, as well as those who have been in this business for a long time, but for some reason are still stuck in a dead spot.

In this article, using private dentistry as an example, we will consider the following issues:

• Why is it hard to start a business?
• 5 principles that will sink your business.
• How to increase customer flow by 30%?
• Businessman or self-employed worker, who are you?
• What will help you create a “tasty” USP?
• Increase dental profits. Where to begin?

Start over.

The collapse of a novice businessman's hopes

What does a novice entrepreneur count on when he opens his own business, in our example, his own dentistry?

The first, of course, is freedom. How long can you work for an “uncle” when you have enormous experience, professionalism and small capital? You can make your dream come true and make a profit...

Dream. Many people strive for it. Each in their own way, based on their experience. And a professional in his field, he takes and leaves his hired job, opens his own business and begins to do what he used to do, only for himself.

The problem is that he is often not ready for this, simply because he does not have such skills. Yes, he is a professional, an excellent dentist, but not a businessman.

And the mistakes that he begins to make inevitably lead to problems in his business.

Let's look at a few mistakes my client made in his field. I would like to note that business processes are similar in many ways and differ only in the specifics of the field of activity, so not only dentists should be aware of these mistakes.

5 principles of “old-fashioned” marketing for dentistry or why you won’t have 300 thousand clients)

What principles are still used by many self-employed businessmen, as well as novice entrepreneurs, what mistakes they encounter and what this leads to will be discussed later in the article.

1. If you want it to be good, do it yourself.

Undoubtedly, an entrepreneur must understand many aspects of his business. However, by doing everything yourself, a colossal amount of time and effort is spent learning and implementing all those technologies, or at least a small part of them, that currently exist on the market.

“Do it yourself” is the principle of being the owner of your work. It is common to dentists, lawyers, attorneys, accountants and other professions engaged in private practice.

This is what distinguishes a business from self-employment. This is the principle that does not allow these people to become business owners and jump in over their heads.

This is understandable, there are 24 hours in a day. During this time, it is impossible for one person to serve an infinite number of patients, much less manage, develop and scale his business.

Classic of the genre, Robert Kiyosaki, “Cash Flow Quadrant”. Businessmen value their time and know that it cannot be returned. Therefore, they buy the time of others and then their day no longer has 24 hours. With someone else's hands they can do much more.

The ability to delegate is one of the key skills that distinguishes a businessman from a self-employed worker. The owner of his business is not limited to one clinic, he builds a network of clinics.

2. Advertising is the engine of trade.

It is IMPORTANT for any entrepreneur, including the owner of a dental clinic, to understand that advertising does NOT increase your sales! No matter how strange it may sound, it is a fact.

Advertising only allows you to increase the number of visits to the clinic. But the administrator who took this call Yes! It largely depends on him whether the client will reach us or go to someone else, more polite, for example.

3. The habit of paying twice.

There are some things you shouldn't skimp on. This is marketing and qualified personnel. I'll explain why.

Firstly, marketing is a system that attracts and retains customers in our company. Without attracting customers there will be no profit. Without customer retention, there will be no stability in business.

According to statistics, attracting a new client is 5-7 times more energy-labor-money-consuming than selling a product or service to an “old” one. Yes! Many dentists make this mistake! They treat their customer as “disposable”, not knowing or forgetting that the customer base is the golden asset of any business.

Secondly, the generated flow of potential clients must be translated into real ones. I wrote about this above in “advertising”. And for this you need a competent manager or administrator who can not only competently talk about the services, but also competently close the sale, so that the client does not even have doubts about choosing which clinic to go to.

Thirdly, the dentist himself and his colleagues must be professionals. Otherwise, “good marketing” will simply “kill” the business of an incompetent doctor. Why?

Because the army of clients created by “good marketing”, dissatisfied and embittered by the quality of services, will spread “the fame of the dentist’s great exploits.” And this is in the most favorable outcome. But there may also be lawsuits and compensation...

Therefore, it is important to be a professional in your field and hire professionals just like you or better!

The desire to save money where it is not worth doing can be very EXPENSIVE in the future.

4. Lack of understanding about your own business.

The lack of knowledge and skills does not allow you to create a viable business model, although it all should begin with an understanding of the business processes that will take place in your clinic.

5. One-time clients.

As practice shows, about 45% of dental clinics treat their clients as “disposable”, that is, they served them, made a profit and that’s it.

This is one of the biggest mistakes. Your customer base is your golden asset. Regular customers are the people who make your business stable.

Repeated sales, according to statistics, are 5 times less expensive than finding new customers and building relationships with them.

What is important for a novice entrepreneur to know and will help those who are “treading water.” We'll talk about this further.

6 rules for increasing dental profits

There are things that are painfully familiar, however, there are still a large number of those who do not use them, especially in offline business.

1. Determine who your target audience is (target audience).

Of course. Where will we go if we don’t understand who our client is? Whom we feed with bait, for whom we write texts, shoot commercials, create banners, headlines, describe values, press on calluses...

It’s trite, but a clear understanding of our target audience allows us to accurately shoot at clients and hit the target, rather than when we have a general blurred idea and fire at sparrows from the Tsar Cannon.

2. Create your USP (unique selling proposition).

Knowing who our client is, we can create a unique selling proposition for him. Or for them, if there are several such groups. Again, the gray masses of an endless number of clinics begin to get lost against the background of the quantity, no matter how good they are.

How can you choose where to go in this case? Help the client, make your unique offer, so that it is the most delicious compared to competitors! What is needed for this?

Yes, it is worth noting here that in many ways these 2 and subsequent points depend on the level of your dentistry: an economy office, an average option or an elite clinic.

3. Use benchmarking.

Study your competitors, look at their tricks: how do they attract customers, generate leads, what tricks do they use offline and online? Analyze, maybe even use their service to know your friend from the inside. Take the best they have and apply it to your clinic or your business.

In addition, identify the obvious shortcomings and weaknesses of your competitors and turn them into your strengths. Then, when choosing between you and someone, they will choose you.

Having analyzed your main competitors in this way, you will have a picture of their strengths and weaknesses. You will see what they offer, what their USP is, what their pros and cons are.

Take all the best, remove the weaknesses and create your own beautiful, bright, “tasty” product that your client will “eat” with pleasure. And you will be happy.))

After all, clients are becoming smarter and don’t go to the first dentist or hairdresser from the bright picture in the advertisement. They analyze what is good and what is bad and where is even better for the same money.

By finding the weaknesses of your competitors and turning them into your strengths, you will stand out from your fellow drillers.

4. Create trust - the source of sales.

The client’s further visit to you and not your competitors depends on what impression the client has about your clinic.

And there are no trifles here. In the literal sense, the client is influenced by everything, from the sign above the entrance and the smile of the administrator, to the cleanliness of the toilet and the presence of soap next to the washbasin.

And of course, the most important thing is the professionalism of the dentist himself. Because it’s one thing when a “soulless” uncle with a stony expression in his eyes treats you, and quite another thing when an open, good-natured, calming person treats you.

Going to a dentist is stressful, unpleasant, and often painful. That’s why we go to him so “often,” usually when we can’t bear it anymore. Routine preventive visits to the dentist have not yet become part of our culture.

To make the client feel comfortable and well, it is important to create trust from the moment the client crosses the threshold of your clinic.

A grateful client will come back to you again and again.

5. Use competent cross-sell.

One of the well-known techniques for increasing profits is cross-selling.
After quality work with the patient, his satisfied, grateful eyes, you can offer him to purchase related products.

Of course, this should not look like an imposed push of a new, super trendy dental floss that penetrates even where others cannot.

The windows of your clinic may contain good toothpastes, brushes, rinses and other oral products that will be truly useful to the client and bring you additional profit.

Without this, neither clients, nor profits, nor business will be visible. And vice versa, from practice, by introducing these simple rules into your business, you can increase the number of clients by 30% in 1-2 months.

6. Money is nothing, REPUTATION is everything!

One serious mistake and your reputation will be completely crushed!

People choose a dentist once and for life. This is of course conditional, but in fact, I would rather go to the other end of the city to see my trusted specialist than go down to the next entrance to the newly opened dental clinic.

Therefore, how much quality or poor quality service you will provide your new patient depends on whether he will become yours for centuries!?) In this way, you, as a professional in your field, personally influence your reputation.

Word of mouth, as a result of your service, the news of the miracle dentist will spread throughout the area. And what this news will be like and how it will affect your reputation depends on how satisfied your client is.

Yes, and of course, it is important to collect positive reviews patients of your clinic, because the principle of social proof has not yet been canceled. The best review is a video review!

Reputation marketing deals with creating and maintaining a reputation. It is impossible to track everything on your own. And the larger your business becomes, the more and better you need to track everything that clients, competitors, media, blogs, social media say about you. networks, etc.

There are often envious well-wishers who, for a number of reasons from psychological to black PR, are one way or another trying to move you from the pedestal of honor of your impeccable reputation.

Reputation is a clean, transparent glass ball, once dropped, the pieces cannot be collected. And even if you collect and glue it together, your reputation will never be the same. Therefore, treat it with care and do not let anyone break it.

This is what reputation marketing is for.

Ask yourself questions:

• Do you know your target audience?
• Do you have a USP that sets you apart from the rest?
• Do you know who your main competitors are and what marketing methods they use?
• Are you building trusting relationships with your clients?
• Do you sell related products?
• Do you care about your reputation as a good specialist?

If there is at least one NO, it's time to think about your marketing!

Finally

Let me summarize.

What is dentistry? This is business. The same business as others, with the same laws, only with its own specifics.

Like any other business, in order to manage it competently you need to have the necessary knowledge, skills and experience. Often, in small clinics and private offices, the dentist himself acts as a businessman.

Being a good specialist in dentistry and being a businessman are two big differences and, as a rule, one excludes the other.

It’s not for nothing that the owners of the most successful network clinics are not dentists. They create this profitable business, open clinics, hire staff, build networks. The ability to manage your own and other people’s time and delegate authority are some of the key skills that distinguish a business owner from the owner of his work.

And you have a choice. If you want to develop your business, you can start doing it yourself by implementing the rules that I wrote about. This will allow you to attract new clients to your clinic. However, remember that this flow will always be limited by your time.

Or hire specialists in this field, let them do it, and you continue to do what you love.

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Subbotin Ivan

Ivan Subbotin Owner of internet marketing agency SaturDay and leading business consultant with a unique focus on social media. He came to this market with one goal, to raise Russian business from its knees. She uses 10 years of experience in digital, internet marketing and social media promotion. Stay in touch with me by joining my social media page on Facebook (

When providing dental services, VAT is not charged under OSNO; are there any other tax benefits for this type of activity? Do I need to submit any additional reports to the tax authorities and funds?

If an organization provides dental services and has the appropriate license, there is no need to pay VAT.

An organization that provides dental services may apply a zero income tax rate if certain conditions are met. The conditions for applying a zero income tax rate for a medical organization are given below in the full answer.

For property tax, additional tax benefits and conditions for their use may be established by the laws of the constituent entities of the Russian Federation. Property tax benefits in 2016 applicable in a specific region are shown in the table at the link: http://www.1gl.ru/#/document/117/20477/?step=80

The law does not provide for other tax benefits for organizations engaged in this type of activity. There is no obligation to submit additional reports to the inspectorate and funds specifically for this type of activity.

What transactions are exempt from VAT?

Situation: is it necessary to pay VAT when selling dental services?

At what rate should I pay income tax?

Reduced rates

For certain types of income, as well as for profits from certain types of activities, paragraphs 1.1–5.1 of Article 284 of the Tax Code of the Russian Federation provide for reduced income tax rates. Such income includes:

11. Income of medical organizations.

With regard to the profits of organizations that conduct medical activities (except for dividends and income from transactions with certain types of debt obligations), if certain conditions are met, a tax rate of 0 percent is applied. This procedure is provided for in paragraph 1 of Article 284.1 of the Tax Code of the Russian Federation. The list of types of medical activities, income from which is taxed at a rate of 0 percent, was approved by Decree of the Government of the Russian Federation of November 10, 2011 No. 917. Moreover, in order to apply the 0 percent rate to medical activities Activities related to spa treatment do not apply.

The conditions for applying the zero rate are defined in paragraph 3 of Article 284.1 of the Tax Code of the Russian Federation. One of them is the relationship between the amount of income from medical activities and the total amount of income received by the organization. This ratio should not be less than 90 percent (). Moreover, if, along with medical activities, the organization provides educational services and (or) is engaged in social services for the population, the income limit of 90 percent must be calculated separately - only for medical activities. If the total income from medical, educational, social activities is 90 percent or more, and from medical activities - less than 90 percent, a zero rate cannot be applied. Such clarifications are given in the letter of the Ministry of Finance of Russia dated July 17, 2015 No. 03-03-10/41223 (communicated to the tax inspectorates by letter of the Federal Tax Service of Russia dated August 14, 2015 No. GD-4-3/14370).

Medical organizations created during the year can apply a zero tax rate no earlier than from the beginning of the next tax period. In accordance with paragraph 5 of Article 284.1 of the Tax Code of the Russian Federation, one month before the beginning of the year from which the organization will charge income tax at a rate of 0 percent, it must submit an application and the necessary package of documents to the tax office. Newly created organizations cannot fulfill this condition, therefore, they have the right to a zero tax rate only from the next year. This was stated in the letter of the Ministry of Finance of Russia dated March 15, 2012 No. 03-03-10/23.

For the same reason, medical organizations that applied the simplified tax regime and lost the right to this special regime within a year are not entitled to apply a 0 percent income tax rate. For the current year, they must charge a tax at a rate of 20 percent and only from the beginning of the next tax period (subject to the fulfillment of the conditions provided for in paragraph 3 of Article 284.1 of the Tax Code of the Russian Federation) will they be able to take advantage of the zero income tax rate. Such clarifications are contained in the letter of the Ministry of Finance of Russia dated August 30, 2012 No. 03-03-06/4/90.

As a general rule, a medical organization that has lost the right to a zero income tax rate can reapply this rate no earlier than five years later (clause 8 of Article 284.1 of the Tax Code of the Russian Federation). This limitation does not apply in the following cases.

First when a medical organization declared an income tax benefit, but never took advantage of it. That is, before the deadline for submitting the declaration for the first reporting period of the year for which the benefit was declared, the organization voluntarily submitted to the tax inspectorate an application for payment of income tax on a general basis (letter of the Federal Tax Service of Russia dated April 5, 2013 No. ED-4-3/6093 ).

Second, when an organization that had already applied a zero rate switched to a simplified tax system, and then returned to the general taxation system. If, after returning to the general system, the conditions of paragraph 3 of Article 284.1 of the Tax Code of the Russian Federation are met, such an organization can immediately continue to use the zero rate. This is stated in the letter of the Federal Tax Service of Russia dated March 17, 2014 No. GD-4-3/4687 (the document is posted on the official website of the tax service).

Who has the right to privileges By tax on property

Types of benefits

Property tax benefits are established in relation to:
– certain categories of organizations;
– certain types of property.

Regional benefits

The laws of the constituent entities of the Russian Federation may establish additional tax benefits and conditions for their use. At the same time, regional authorities have the right to establish benefits similar to federal ones, but without the time limits provided for them. This follows from the provisions of paragraph 2 of Article 372 of the Tax Code of the Russian Federation. The effect of regional benefits is limited to the territory of the corresponding constituent entity of the Russian Federation (letter of the Ministry of Finance of Russia dated October 22, 2007 No. 03-05-06-01/120).

For each category of beneficiaries, special conditions may be provided that must be met in order not to pay property tax. For example, in the Moscow region, the use of benefits is made dependent on whether the organization allocated the saved money for certain purposes or not (Chapter 2 of the Moscow Region Law of November 24, 2004 No. 151/2004-OZ).

The table will help you find out what property tax benefits are in effect in a particular region in 2016.

What insurance premium rate should be applied if the policyholder has no benefits or additional obligations?

By default, insurance premiums must be calculated at the following rates:

• 22 percent - for pension insurance;
• 2.9 percent - for social insurance;
• 5.1 percent - for health insurance.

These basic rates are set for most policyholders. In addition to basic tariffs, there are also reduced, additional and special tariffs, which are provided for specific groups of policyholders.

Reduced rates paragraph 9 of part 1 and part 3.3 of article 58 of the Law of July 24, 2009 No. 212-FZ.

You can confirm your right to reduced insurance premium rates with certain documents. Their complete list is given in the table. There is no need to specially submit these papers to the funds. They will be needed when fund inspectors check the company's accruals.

Decree of the Government of the Russian Federation of November 10, 2011 No. 917

List of types of educational and medical activities carried out by organizations for the application of a tax rate of 0 percent for corporate income tax

2. Types of medical activities

Dentistry

Dentistry for children

Preventive dentistry

Orthopedic dentistry

Dentistry therapeutic

Surgical dentistry

Forensic-medical examination

Registration of dentistry is a rather labor-intensive and complex process that takes a long time. A mandatory requirement for registering dentistry with the Federal Tax Service is having a medical license. If you plan to open a private practice or a dental office, then it is necessary to prepare documents as an individual entrepreneur, but if the activity is more extensive, in the format of a dental clinic, then you need to register a legal entity, for example, an LLC.

What is needed to register dentistry?

If you have a medical education and work experience in dentistry, you can create your own business in this field, and for these purposes you will need to register with the Federal Tax Service as an individual entrepreneur (IP). You must understand that only an individual can obtain a medical license, therefore, if you do not have the necessary education and experience, you will have to register a legal entity and obtain licenses for the employees who will work for you.

When registering dentistry with the Federal Tax Service, the following must be indicated in the activity codes (OKVED):

• 85.12 Medical practice;
• 85.13 Dental practice.

The next steps will be registration with funds (FSS, Pension Fund), drawing up a ledger for accounting expenses and income, ordering a seal and opening a bank account.

After this, you should buy a cash register (KKM), enter into an agreement for its maintenance and support, and register the corresponding journal with the Federal Tax Service.

The requirements that a room equipped for dentistry must satisfy are listed in the following regulatory documents:

• SanPiN 2.1.3.2630-10;
• SanPiN 2956a-83.

Sometimes regional regulations are additionally applied, in accordance with which activities in the dental field are conducted.

The most stringent requirements are imposed by Rospotrebnadzor on the area of ​​dental premises. Thus, to operate one dental unit in the office you need at least 14 square meters. m of free space. Each additional device will require another 7 square meters. m. It follows from this that to open a dentistry with one workplace, the office area should be about 30 square meters. m (which is comparable to the size of a one-room apartment). When calculating the size of the room that will be required for arranging the dentistry, you also need to include the area of ​​the toilet room (5 sq. m) and the hall (102 sq. m).

If financial capabilities allow, then the best option is to purchase premises for dentistry as personal property. And, if at the time of purchase it belongs to the residential stock, it is necessary to transfer it to non-residential. Additionally, you will need to submit applications for the formation of premises designs: architectural, technological, electricity and water supply, sewerage, and in some cases ventilation. All these plans are agreed upon by the following authorities:

• State Fire Inspectorate bodies;
• TU Rospotrebnadzor;
• architectural and planning management;
• state examination.

Next, you will need to make repairs taking into account some features: the dental chair must be connected to the sewerage system, water and electricity supply, and for this it will be necessary to lay a whole network of communications under the floor. You will also need to install an alarm, carry out ventilation, etc.

What requirements must be met for licensing and registration of dentistry?

Licensing requirements are fixed in the relevant regulations on licensing of certain types of activities, however, all basic requirements are listed in the current legislation of the Russian Federation. In paragraph 7 of Art. 3 of Law No. 99-FZ states that their main task is to ensure the achievement of licensing goals.

1. Requirements for the presence of buildings or premises. Medical institutions must own or lease a building, structure, structure, or premises. In order to confirm the right to rent, you will need to present a signed contract for renting premises for dentistry. In addition to the specified grounds, the use of real estate under operational management is permitted. In this case, the supporting document will be a certificate of state registration of such right.

2. Requirements for premises. The main and most important requirements for the premises used are the conditions of SanPiN, recorded in the Decree of the Chief State Sanitary Doctor of Russia dated May 10, 2010 No. 58 “On approval of SanPiN 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations engaged in medical activities” .

Requirements for the procedure for providing medical care also apply, which, among other things, describes the standards for equipment of premises for the provision of certain types of medical services.

3. Requirements for medical devices. An individual entrepreneur planning to register dentistry must prove that he has the necessary medical equipment and drugs to provide dental services and carry out related work. The legal basis for such ownership is documented: supply agreements, invoices, certificates, etc. are provided. Renting of necessary medical products is also allowed.

According to paragraph 1 of Art. 28 of Law No. 323-FZ, medical products are any types of instruments, instruments, materials, equipment, as well as specialized software that are used for preventive, diagnostic and therapeutic purposes (depending on the manufacturer’s recommendations) to check the health status of patients, rehabilitation, replacement, restoration, research, correction of the anatomical structure and natural functions of the body. At the same time, medical products do not have a pharmacological, immunological, genetic or metabolic effect on humans.

4. Requirements for state registration of medical devices. The person involved in registering dentistry must provide information on the state registration of medical products (instruments, instruments, equipment, devices required for the provision of medical services and medical work).

The procedure for the circulation of medical devices in the Russian Federation is determined by Decree of the Government of Russia dated December 27, 2012 No. 1416 “On approval of the Rules for state registration of medical devices.” Their registration is carried out by the Federal Service for Supervision in the Sphere of Health. To confirm the presence of state registration of specific medical products, you must present a certificate for each of them, the form of which is established by the relevant registration authority. However, this document does not have a validity period.

Medical products created on the basis of individual client orders are not subject to state registration, but they must be manufactured by employees of a medical institution, who are subject to special requirements. Only the patient who ordered them has the right to use such products.

5. Requirements for the qualifications of management personnel. Requirements for the education and qualifications of the director of dentistry and his deputies or heads of departments responsible for the provision of medical services are determined by the Regulations on licensing of medical activities.

Based on Order of the Ministry of Health of the Russian Federation No. 1183-N dated December 20, 2012 “On approval of the Nomenclature of Positions of Medical Workers and Pharmaceutical Workers,” dentistry can be managed not only by the chief physician, but also by other persons holding leadership positions.

As a result of the entry into force on January 1, 2016, Art. 69 of Law No. 323-FZ, it became possible to replace a specialist’s certificate with a certificate of accreditation of a medical worker.

The transition period is also defined by law: on the basis of Part 1.1 of Law No. 323-FZ, it lasts from 01/01/2016 to 12/31/2025. The terms and stages of accreditation of medical workers are also indicated in the order of the Ministry of Health of the Russian Federation No. 127-N dated 02/25/2016 d. Additionally, this document contains information about the categories of persons with pharmaceutical, medical or other education, and about those specialists who need to undergo accreditation. Based on this order, in 2016, university graduates in the fields of “Dentistry” and “Pharmacy” are required to undergo this procedure, and in 2017 - “Medical and preventive care”, “Pediatrics” and “General medicine”. Thus, by 2026, all medical and pharmaceutical workers must undergo the accreditation process.

Certificates of specialists received before 01/01/2021 will be valid until the end of the period specified therein.

6. Requirements for work experience in the specialty for managers. To obtain a license, dental directors, their deputies, heads of departments and individual entrepreneurs must provide proof of at least five years of work experience in the relevant field. In this case, it is mandatory to have a higher medical education. If an individual entrepreneur has received only specialized secondary education, then his work experience must be at least three years: here the conditions are not so strict.

7. Requirements for the availability of staff units and their qualifications. The person applying for the license must confirm that all employees hired into dentistry on the basis of employment contracts have secondary, higher, postgraduate and/or additional medical education. This is required to provide the declared services and carry out work. Also, employees of a medical institution must have specialist certificates (this applies to employees with medical education).

8. Requirements for the qualifications of medical personnel. Employees with incomplete higher education have the right to work in nursing positions only. The basic principles for allowing such employees to work are set out in Order No. 23-N of the Ministry of Health and Social Development of Russia dated March 19, 2012.

9. Requirements for job titles and staffing. Quite stringent requirements have been established for medical organizations, including in job titles. Thus, they cannot be designated arbitrarily; their names are regulated by Order of the Ministry of Health of the Russian Federation dated December 20, 2012 No. 1183-N “On approval of the Nomenclature of Positions of Medical Workers and Pharmaceutical Workers.”

The determination of job titles in dentistry occurs in accordance with the names of specialties approved by Order of the Ministry of Health of the Russian Federation dated October 7, 2015 No. 700-N and Order of the Ministry of Health and Social Development of the Russian Federation dated April 16, 2008 No. 176-N.

The formation of staffing standards for all employees of a medical institution is carried out depending on the procedure for providing medical care. They are required to be carried out only by government organizations providing medical services. In all other institutions, the standards are advisory in nature.

10. Requirements for the system of internal quality control and safety of medical activities. One of the main conditions for issuing a license to a medical organization is the implementation of internal control of the quality and safety of the provision of medical services. However, today there are no regulations defining the procedure for its organization.

Part 2 of Article 87 of Federal Law No. 323-FZ indicates possible ways to verify the quality and safety of the provision of medical services and ways to monitor and record medical activities, including the development of a scheme for assessing the work of medical personnel providing services of this kind.

Now the main legislative act regulating quality and safety control, as well as supervision in the field of medicine and healthcare, is the Decree of the Government of the Russian Federation of November 12, 2012 No. 1152 “On approval of the Regulations on state control of the quality and safety of medical activities.” This document contains requirements for organizations operating in the field of medicine. On the basis of this act, it is necessary for medical institutions to carry out internal quality control of the services provided, but a specific procedure is not defined.

How to obtain a medical license to register dentistry

Explanations regarding licensing of dental activities are given in Decree of the Russian Government dated 04/07/2008 No. 241, according to which licenses can be issued in the following areas of dentistry:

1. Orthopedic dentistry - the task of the orthopedist is to restore the patient’s lost teeth, as well as to eliminate the traumatic effect on them, as well as on the bone tissue and gums.

2. Pediatric dentistry - is mandatory licensed and is allocated to a special field, since these specialists need to understand both the physiological and mental characteristics of the child’s body.

3. Therapeutic dentistry - treatment of caries at all stages and in various manifestations.

4. Preventive dentistry is a set of measures to prevent caries and other diseases of the oral cavity.

5. Surgical dentistry - tooth extraction and various operations in case of diagnosis of periodontitis, odontogenic abscesses or periostitis.

6. General dentistry is a situation in which an individual entrepreneur in one person provides all types of the services listed above.

The license you receive must determine the period during which you have the right to provide dental services, and at the end of it, you can renew the license without re-collecting the original documents.

Thus, when submitting an application for a license for the first time to the relevant authority, you must provide:

• constituent documents;
• papers confirming the qualifications and work experience of the applicant;
• conclusion of the sanitary and epidemiological station;
• documents confirming the applicant's ownership of real estate used for dentistry, or a lease agreement.

These documents can be reviewed for a maximum of 45 days.

The following documents and information are provided to the Ministry of Health for licensing purposes:

1. Application for a license signed by an individual entrepreneur, the head of the executive body of a legal entity or another representative of the organization with the appropriate authority.

4.Copies of documents confirming the presence of:

• for the head of dentistry and his deputies or heads of departments of other organizations responsible for medical activities - higher medical, postgraduate or additional professional education in accordance with the qualification requirements for employees with higher and postgraduate medical education in the field of healthcare, a specialist certificate, as well as additional professional education and certificate of a specialist in the profile “health care organization and public health”;
• for the head of a structural unit of a medical institution providing dental services - higher professional education and/or additional professional education in accordance with the qualification requirements for employees with higher and postgraduate medical education in the field of healthcare; specialist certificate - for workers with medical education.

5.Copies of documents confirming that the above persons have the following work experience in dentistry:

• at least three years for employees with secondary medical education;
• at least five years for employees with higher medical education.

6. Data on the issuance in a certain order of a conclusion from the sanitary-epidemiological service confirming the compliance of the premises planned for use as dentistry with all sanitary rules.

7. Information on state registration of medical products, including equipment, instruments, etc., required for the provision of dental services.

8.Copies of documents confirming availability:

• for persons who have concluded employment contracts with the applicant for a license, with higher, secondary, postgraduate and/or additional medical or other professional education required for the provision of the declared services, relevant documents confirming this fact, as well as a specialist certificate - for persons with a medical education;
• persons who have entered into employment contracts with the applicant for a license for the maintenance of medical devices, including equipment and instruments, relevant professional education and (or) qualifications, or a copy of the contract with a company holding a license to conduct such activities.

9. Inventory of documents provided.

When reorganization of a legal entity The conversion form will require the following documents:

In a situation where a legal entity has reorganization in the form of merger, then, if all institutions participating in this process already have a valid license for the same types of medical services, the following documents are provided:

1. Application for renewal of a license.
2. Original license to conduct medical activities.
3. Description of the documents provided.

At changing the name of the organization, the address of its location or full name, address of place of residence or registration, details of the identity document of the individual entrepreneur are provided:

1. Application for renewal of a license.
2. Original license to conduct medical activities.
3. Description of the documents provided.

In order to re-registration of license in a situation where its owner plans to change the address at which medical services are provided, the following documents are required:

2. Copies of documents providing the basis for ownership or lease of premises, buildings or other real estate on the territory of which dental services will be provided, if such rights are not recorded in the Unified State Register of Rights to Real Estate and Transactions with It. In a situation where rights are registered in it, information about real estate is provided.

3. Copies of documents confirming the applicant’s ownership or other legal basis of medical products, including equipment, instruments, etc., which will be required for the provision of dental services.

In order to re-registration of license in a situation where it is planned to provide other services in the field of medicine, it is necessary to list them in the corresponding application, as well as provide the following documents:

1. Application for renewal of a license.

2. Copies of documents providing the basis for ownership or lease of premises, buildings or other real estate on the territory of which dental services will be provided, if such rights are not recorded in the Unified State Register of Rights to Real Estate and Transactions with It. In a situation where rights are registered in it, information about real estate is provided.

3. Copies of documents confirming the applicant’s ownership or other legal basis of medical products, including equipment, instruments, etc., which will be required for the provision of dental services.

4. Information on the issuance, in a certain order, of a conclusion from the sanitary-epidemiological service confirming the compliance of the premises planned for use as dentistry with all sanitary rules.

5. Data on state registration of medical products, including equipment, instruments, etc., required for the provision of dental services.

6.Copies of documents confirming the presence of:

• for persons who have entered into employment contracts and who have higher, secondary, postgraduate and/or additional medical or other professional education required for the provision of the declared services, relevant documents confirming this fact, as well as a specialist certificate - for employees with a medical education;
• persons who have entered into employment contracts for the maintenance of medical devices, including equipment and instruments, relevant professional education and (or) qualifications, or a copy of the contract with a company holding a license to conduct such activities.

7.Original license to conduct medical activities.

8. Inventory of documents provided.

In order to re-registration of license in a situation where work at the previously specified address(es) is terminated or the previously formed list of services provided is changed in terms of excluding certain items, the following documents must be presented:

1. Application for renewal of a license.
2. Original license to conduct medical activities.
3. Description of the documents provided.

If it is planned to cancel the license in accordance with clause 1, part 13 of art. 20 No. 99-FZ dated 05/04/2011, you will need to fill out an application for termination of medical practice with the obligatory indication of the date from which the activity was actually stopped.

If necessary obtaining a duplicate license The following documents will be required:

1. An application for the issuance of a duplicate license indicating the details of the document on the basis of which the corresponding state duty was paid.
2. If a previously issued license was damaged, its form is also attached.

If you want to get a copy of the license, then it is enough to fill out the appropriate application.

In order to obtain information and a license indicated in the state register, it is also necessary to fill out an application on behalf of an individual or legal entity.

All documents or copies thereof, as well as completed applications that are required for re-issuance or initial issuance of a license (its duplicate or information from the registry), can be provided both in paper and electronic form. In this case, a package of such electronic documents must be signed with an enhanced electronic signature of the applicant or another person acting on his behalf legally, using information and communication technologies or the Unified Portal of State and Municipal Services.

What documents will be needed to register dentistry as an individual entrepreneur?

To register as an individual entrepreneur, an individual must submit a corresponding application to the tax office at the place of registration. You should first carefully prepare a package of documents necessary for this, namely prepare:

1.Identity document. Additionally, you will also need copies of all completed pages of the passport, which will need to be correctly certified (stitched, numbered, indicate the number of sheets in the binding, affix a certification along with the date, surname, first name and patronymic of the witness, as well as his position).

If the document does not contain a mark indicating the registration of an individual at the place of his stay/residence, then it is necessary to provide another document in which it is present.

If a citizen of a foreign state applies to register as an individual entrepreneur, he will need to provide copies of his identity document, translated into Russian and duly certified by a notary. Additionally, you will need documents confirming the right of stay/residence, as well as the right to carry out work activities of a foreign citizen in the territory of the Russian Federation.

If you provide a package of documents using Russian Post or through an intermediary, you must have everything notarized.

2. TIN certificate. Upon completion of the application, all individuals are assigned a unique number - a taxpayer identification number (TIN). If you have previously worked for hire in an organization or enterprise, then you probably already have one. Since this number is important when concluding an employment contract, it is necessary to provide the original or copy of the relevant certificate.

To check whether you have been assigned a taxpayer identification number, you can go to the official website of the Federal Tax Service. If, based on the results of the check, it turns out that such a number does not exist in your name, then simultaneously with all other documents you will also need to fill out an application for a TIN, since without this document it will not be possible to open a dentistry.

3.IP registration application. The application sent when registering an individual as an individual entrepreneur is filled out on form P21001, which is regularly subject to changes. Before completing it, it is recommended to study the current sample for filling out, which is posted on the official website of the Federal Tax Service.

Please note that any inaccuracies, including errors, blots, etc., are not allowed. In this case, the identification information of an individual must completely duplicate the information specified in the identity document.

Thus, the main details that must be indicated when filling out this form are as follows:

1. Full name of the applicant (indicated without any abbreviations).
2. Full name of the applicant in Latin letters (when registering as an individual entrepreneur of a foreign citizen).
3. Letter abbreviation of the applicant's gender (“M” or “F”).
4. Date and place of birth of the applicant (in full accordance with the column in the passport).
5. Citizenship.
6. Registration address of the future individual entrepreneur.
7. Landline telephone number (if there is a code, it is indicated along with it).
8. Planned activities.
9. Details of the identity document.
10. Sections 10 to 12 are completed by minors.
11. TIN of an individual and his signature.

Special attention should be paid to filling out Appendix “A”. In order to quickly complete this document, you must first decide on the types of activities that you plan to carry out (OKVED). Thus, depending on the main one, the volume of transfers to the Russian Social Insurance Fund will be determined. However, if one or more activities are changed, additional costs may be required.

OKVED and its decoding must be indicated in the application. The completed form will need to be notarized, and if documents are provided through an intermediary, a power of attorney, confirmed in a similar way, should also be issued for it.

Today, registration as an individual entrepreneur can be completed remotely, using the Internet.

4.Payment document confirming payment of state duty. To register as an individual entrepreneur, you must pay a state fee, the amount of which is determined by law. The fact of its payment will need to be confirmed documentaryly (terminal check, receipt or receipt order). Since 2015, the amount of state duty for registering an individual entrepreneur is 800 rubles, and the details for its transfer can be clarified directly at the regional division of the tax inspectorate.

So, listed above are all the documents that will be required to register an individual as an individual entrepreneur. It should be understood that if there are errors in the documents or an incomplete set of papers is provided, the amount of the state fee will not be refunded, that is, when re-filling the application, you will need to duplicate its payment. Therefore, when preparing documents for opening a dentistry, you need to be as careful as possible.

What package of documents is required to register dentistry as an LLC?

To register dentistry as an LLC, the following documents will be required:

1. Application for registration (form P11001).

2. A document confirming payment of the state duty.

3. Charter of the LLC (in two copies).

4. The decision of the founder or the minutes of the meeting (if there is more than one founder) on the creation of an LLC.

5. Agreement confirming the creation of the LLC.

One of the main documents when registering an LLC is the corresponding decision of the founder.

If there is only one creator, then his decision must be recorded in writing. This document also indicates the name of the organization in different forms (full, abbreviated), the name and address of the authorized management body, information about the director, and the size of the charter capital. In the registration document itself, it is necessary to indicate the fact of making a decision to approve the charter of the LLC, as well as indicate the details of the person who will have the right to represent the interests of the organization in the process of registration of dentistry.

The minutes of the meeting (if there are several founders) are similar in purpose and parameters to the decision of the sole creator, and therefore include the same information. When registering dentistry as an LLC, this document also indicates information about the signing of a collective agreement, the share of each founder in the management company (in total and percentage terms). The serial number of these documents (decision or protocol) will always be the first.

The agreement on the creation of an LLC is concluded in a situation where there is more than one founder of dentistry and contains information that generally duplicates the information from the protocol, but in a more detailed and elaborate version. An agreement on the creation of an LLC is drawn up in the number of copies corresponding to the number of founders, plus one more, which is ultimately sent for registration of dentistry with the Federal Tax Service.

The charter is the founding document for dentistry in the form of an LLC. It determines many nuances of the organization’s activities, including the entry and exclusion of a person from the founders, distribution of capital, etc. In this case, a prerequisite is full compliance of the provisions of the charter with Russian legislation.

The founders are not listed directly in the text of the charter, but they are required to put their signatures on its last page. All other documents required for dental registration must also be completed and signed by all participants. In the future, if it is necessary to make changes to the charter of the LLC, the consent of all its founders will be required.

Before sending a set of documents for registration of dentistry to the Federal Tax Service, the signatures of all founders must be notarized. In this case, the general director takes on an additional function - he acts as an applicant when sending documents.

The process of registering a dental practice as an LLC will require the following expenses:

1. Certification of the application by a notary - 1,000 rubles for each signature.

2. Registration of a notarized power of attorney - 1,260 rubles.

3.Payment of the state fee for registering an LLC - 4,000 rubles.

You may also need to pay for the following additional services, which are not mandatory:

• providing the registration address and its postal service;
• registration with the Social Insurance Fund (in Moscow included in the price);
• registration with the Pension Fund of the Russian Federation (in Moscow included in the price);
• preparation of a set of documents for the purpose of opening a bank current account;
• notarization of registration documents;
• production of additional seals or seals with protection.

Documents and information required for registration of dentistry in the LLC form:

• name (full, abbreviated and, if necessary, in Latin);
• registration address, actual location address;
• information about the general director (copy of passport, taxpayer identification number);
• declared types of activities (OKVED and decoding of codes);
• taxation system (simple or simplified);
• the volume of the charter capital and its ratio between the founders;
• contacts: telephone numbers (fax), email address;

· data of the founders: for individuals who are citizens of the Russian Federation - a copy of the passport and TIN; for non-resident individuals - a translation of the national passport certified by a notary; for legal entities - residents of the Russian Federation - a card with details; for foreign legal entities - a translation of apostilled constituent documents certified by a notary.

After completing the LLC registration procedure, the founders will be given the following documents:

• agreement on the creation of an LLC (if there is more than one founder);
• decision or protocol on the establishment of an LLC;
• charter;
• certificate of registration with the tax office (TIN);
• certificate of state registration (OGRN);
• list of participants;
• extract from the Unified State Register of Legal Entities;
• Unified State Register of Legal Entities sheet;
• notification of registration with statistical authorities;
• notification from the Pension Fund (outside Moscow - additional service);
• notification from the Social Insurance Fund (outside Moscow - additional service);
• administrative documents on the appointment of the general director and;
• in case of choosing a simplified taxation system - an application for transition to the simplified tax system with a mark from the Federal Tax Service;
• seal.

For what reason may dental registration be denied?

Registration of an individual entrepreneur may be denied for the following reasons:

1.The information in the registration application is incorrect.

2. Inconsistency of personal data in the application.

3. Information about the applicant is already available in the state register.

The tax office issues a refusal to register dentistry in writing, indicating the reasons, and transfers it to the applicant along with a set of primary documents. The application for registration can be re-submitted after all the specified deficiencies have been eliminated, however, as a rule, the main reason for refusal to register dentistry is the inability of the person to work in the entrepreneurial field.

It is possible to refuse registration of a legal entity in the following cases:

1. Indication of incorrect or fake information in the registration application.

2. Errors in the charter.

3. Absence of a mark on registration of the charter or a corresponding extract.

4. Inconsistency of the founder’s data.

5. Mismatch of legal address.

As a rule, once the necessary changes have been made and errors have been corrected, the result of resubmitting the application is positive.

A license may be refused in the following situations:

• the pre-screening licensee does not meet the established requirements;
• incorrect information is provided that differs from the information specified in the original registration documents.

Refusal to issue a license is issued in the form of an order from the authorized body, which must list the reasons and also provide references to the legislation. The average time for preparation and delivery of a response is 3 business days. This decision can be sent by Russian Post in the form of a registered letter or received personally by the applicant. If the licensee does not meet the established requirements, the details of the inspection report that served as the basis for such a conclusion are also indicated.

The applicant has the right to appeal the decision to refuse to issue a license in court if he is confident that the documents comply with all established requirements or in case of failure to comply with the deadlines for obtaining a license. Such an appeal is possible until the expiration of three months from the moment the violation was recorded.

In a situation where an employee of an authorized body refuses to issue a license without legal grounds or violates established deadlines, it is possible to impose a fine on him in the amount of 3,000 to 5,000 rubles (in accordance with the Code of Administrative Offenses). If additional additional payments and documents are required, the amount of such a fine can be increased to 5-10 thousand rubles.

"Chief Accountant". Appendix "Accounting in Medicine", 2006, N 1

VAT WHEN PROVIDING DENTAL CARE

Despite the fact that the law provides for a benefit for medical services, its application is limited by the established List of these services and other regulations. The question arises: are dental services in private organizations subject to VAT? Let's figure it out together.

Features of taxation in dentistry

Paid services to the population, in addition to the guaranteed volume of free medical care, can be provided by medical institutions, regardless of departmental subordination and form of ownership. This is stated in paragraph 1 of the Rules approved by Decree of the Government of the Russian Federation of January 13, 1996 N 27. This means that private enterprises also have the right to provide paid dental services, and at the same time, in accordance with Art. 143 and 146 of the Tax Code of the Russian Federation, in general, they are recognized as VAT payers. But this is in general, but there are also specifics in this matter.

VAT benefit

Thus, subject to certain conditions, the legislation provides for preferential tax treatment for medical services. Let us consider in order the reasons for its use. This is the Tax Code of the Russian Federation, which states that the sale of medical services provided by medical organizations, including doctors engaged in private medical practice, is exempt from taxation (clause 2, clause 2, article 149).

What services are eligible for this benefit? They are listed in the List of medical services for diagnosis, prevention and treatment provided to the population, the implementation of which, regardless of the form and source of payment, is not subject to VAT (approved by Decree of the Government of the Russian Federation of February 20, 2001 N 132). Dental services are included in the specified List and are provided within the framework of primary (pre-hospital) medical care, outpatient medical care and in day hospitals, and therefore are exempt from VAT. At the same time, an organization applying for preferential treatment must have documents confirming this right.

Note. Official position

S.V. Sergeeva, Advisor to the Tax Service of the Russian Federation, III rank

Are dental services provided to the public subject to VAT?

According to paragraphs. 2 clause 2 and clause 6 art. 149 of the Tax Code of Russia, the provision of services to the population by medical organizations and (or) institutions, doctors engaged in private medical practice, with the exception of cosmetic, veterinary and sanitary-epidemiological services, is not subject to taxation (exempt from taxation). Medical services, in particular, include services provided to the population for diagnosis, prevention and treatment, regardless of the form and source of payment, according to the List (approved by Decree of the Government of the Russian Federation of February 20, 2001 N 132), if organizations have, carrying out these operations, the appropriate licenses.

Documents that confirm the right of an organization providing dental services are appropriate licenses. Their presence is provided for by law and other regulations. This is clause 6 of Art. 149 of the Tax Code of the Russian Federation, clause 3 of Rules No. 27, Regulations on licensing of medical activities (approved by Decree of the Government of the Russian Federation of July 4, 2002 No. 499), Order of the Ministry of Health of Russia of July 26, 2002 No. 238. I would like to draw your attention on a number of significant points:

If there are no appropriate licenses or their validity period has expired, the tax authorities have the right to impose VAT on operations for the provision of dental services, since the use of the benefit is allowed only if there is a license;

Dental services provided specifically to the population are exempt from VAT. If the organization serves legal entities, VAT should be charged.

Inspectors may require the submission of documentation confirming the right to use the preferential treatment as part of a desk audit within three months from the date of filing the declaration. This right is enshrined in Art. 88 of the Tax Code of the Russian Federation.

General Audit Department Specialist

Baker Tilly Rusaudit LLC

E.Ya.SERGEEVA

Signed for seal

28.02.2006

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