Preventing Fraud in the Dental Office

Three simple steps can help protect your financial security:

  1. Ensuring that the clinical dentistry you provide
  2. is correctly posted to the patient’s account
  3. Posting fees and payments to the proper account

The vast majority of offices depend on administrative staff to properly safeguard the financial health of the practice. As we all know, with technology advances in practice management, patient data is often siloed into multiple systems that do not interact. This provides innumerable ways for a dishonest individual to steal income in small “unnoticeable” increments that can quickly aggregate to hundreds of thousands of dollars in embezzled funds. It is very important that dentists and loyal staff implement and monitor proven internal financial controls to prevent the possibility of jeopardizing their livelihoods.

The following efforts are low-cost or free, and can be implemented relatively quickly:

 

1. You can perform a fast, inexpensive audit yourself. If your practice is large, run reports that provide you with the following data:

  • For each location and provider, pull 15 random patient charts from the past month’s schedule. Confirm that the treatment
    performed was posted to each patient’s account and check to see that that patient’s payment (check or cash) was posted both to his or her account and the bank deposit. Then, confirm that the bank receipts reflect the same amount as the daily in-house deposit amount.
  • If you do not find any discrepancies in these 15 patient records, your practice is probably clear of embezzlement activity from patient accounts, although this is never guaranteed
  • Plan on performing the 15-patient chart audit each week. At the end of your audit, leave the charts at the front desk. Add a note stating you are finished with your audit and the charts can be fi led. If you are paperless, tell your CPA and office manager that you are logging in to review patient records regularly. This is a very non-threatening way of notifying your staff that you review records for your own follow-up needs. It is best if you do not detail these specifics to your staff.
  • Support this brief audit process by having your bank statements sent to your home.

2. Lock down your internal controls. The following are essential to creating self-sustaining fraud prevention in your practice:

  • Segregate bookkeeping duties between employees to eliminate total financial access by any one employee.
  • Control adjustments, write-offs and refunds by reviewing all adjustments and each entry of your monthly adjustment report.
  • Implement strict cash processing rules with segregated receivables/deposit personnel.

3. Implement financial monitoring services.

For example, Practice SafeGuard™ is a financial monitoring platform designed by Certified Fraud Examiners who combine a unique array of clinical dentistry and global intelligence expertise. Practice SafeGuard™ will allow you to monitor and protect your income in a convenient way. It’s a web tool that retrofits to your entire accounting history and alerts any device you carry to extreme or unusual transactions, so that you can respond to potential issues instantly. Please visit www.PracticeSafeGuard.com to learn more.
Some of these processes cost nothing to implement compared with the potential loss of thousands. Closely analyze your monthly reports in open view of your staff. Letting your staff members see you pore over the books is not to imply a lack of trust, but to demonstrate that you have an active role in the administration of the business.

Trust But Verify – ADA News Article

The American Dental Association Featured an Article written by Dr. Lewis in their December 2011 issue- Trust But Verify — Protecting Your Practice From Embezzlement.    Click on the Image Below to read the scanned Article!

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DentistryIQ

Dr. Lewis writes for the great team at Pennwell Publishing and DentristryIQ .  Check out our quick story on their site outlining a concise list of 4 tips in plain english, to protect you from embezzlement.

Read the Story at Dentistry IQ.

Thanks!

 

Office Scams

Originally written by Stephanie Sisk of the Chicago Daily, February 26th, 2009.

Ohio dentist Donald Lewis Jr. wants to share his pain and have others learn from it. Fifteen years ago, with a full schedule and busy office, Dr. Lewis didn’t realize a sra ff member was stealing from him. It took him three-and-a-half years to recoup the losses and build up his practice again, and it sparked in him a passion to warn others about the ins and outs of scams and schemes in the dental office.

“This has been a IS-year crusade,” Dr. Lewis said, noting that dental schools offer little to no education in business skills, let alone office fraud detection. His Saturday lecture “Doctor, Your Check Bounced Again” offers ways to protect your office from fraud.
Crime insrigated by employees is particularly painful, Dr. Levlis said. Dentists, he said, are trained professionals who want to “do the best job we can” and trust that the staff he or she hires wants to do the same. But sometimes that trust is abused and exploited, and the busy doctor is often blindsided by the scope of the scam and by the betrayal of someone considered a loyal staff member.

A lack of internal controls and employee supervision and oversight are often to blame for office scams, Dr. Lewis said. He urges dentists to have an external, independent audit and lise a forensic accountant not only to make sure revenue and expenses are legitimate, properly recorded and in sync, but also to sniff out discrepancies. “Doctors think of accountants as people to handle their taxes. But (most) accountants aren’t looking at what’s being produced in rhe office , who’s doing collections” or other transactions recorded by staffers. An audit would track those finer details and uncover problems, Dr. Lewis said. Computer fraud is the basic building block in office scams.
There are at least 475 ways computers can be used to manipulate office records, Dr. Lewis said. Altered payroll and receivables records, backdated credit slips and illicit refund checks illustrate just a fraction of computerized records that can be changed to cover theft. Equally alarming is the threat posed by savvy computer hackers.
“Hacking is a huge, huge problem ,” Dr. Lewis said. Installing firewall programs is essential ror an office to protect both employees and patients from identity theft.
While the possibility of an office scam is one most dentists don’t want to think about, Dr. Lewis warns that they “can’t bury their head in the sand.” An undiscovered, long-term scam can lead a dentist to bankruptcy, loss of the practice and reputation, and family break-up. “It’s a very, very horrible time,” he said.

Scams and Schemes in the Dental Office

When a trusted employee embezzled a hefty sum from Dr. Donald Lewis’ dental practice, the oral surgeon was destroyed financially, professionally, and psychologically, he recalls.

That was 20 years ago. Since then, his Cleveland-based practice has regained solid footing and he’s on a mission to share his story with other demists. His workshop, ” Doctor, Your Check Has Bounced Again !,” is helping new dentists and experienced practitioners learn to protect their practice from embezzlement and fraud. [Read more...]

Financial misappropriation of the dental practice

This article taken from Dental Economics, January 2010. Article by Donald P. Lewis Jr., DDS, CFE.

In my seminars, I’m often asked to discuss the key internal
controls necessary to help proactively prevent the misappropriation of funds in the dental office. Internal controls can cover a multitude of subjects dlat can include any issue pertaining to the financial management of the practice. For purposes of this article, I’ll narrow these down to some of the more basic internal controls that absolutely need to be in place….

ODA member learned $80,000 lesson & now shares tips on avoiding embezzlement

Annual Session speaker to share tips on avoiding employee embezzlement -(Ohio Dental Association Conference)

Lewis went through a gamut of emotions: shock, anger, denial, hurt.  There was no doubt that the employee had stolen the money – the issue now was how it would be handled – and prosecution was the right choice, he said, because he had to prevent this from happening to others.

Protect Your Office – from DentalEconomics.com

Embezzlement in the dental office is a growing concern.
But there are ways you can protect your office.  From inside the article:

Embezzlement schemes

The methods of embezzlement are limited only by the individual’s imagination.  Here are just a few:
Skimming - In one of the simplest embezzlement schemes, cash received from a patient’s payment is simply “skimmed” or removed from the practice and remains in possession of the thief. This can be done by not making any record of t he transaction. Cash is received but not recorded; therefore, the transaction does not appear on thee accounts receivable records. A scam of this nature is extremely difficult to prevent or even detect. To reduce the likelihood of – or even the temptation to commit – this type of fraud, use prenumbered invoices or cash receipts at all times when receiving cash in your practice. Use these receipts regardless of the amount of cash being paid. Spotchecks also can help as…. [Read more...]

How Can You Protect Yourself from Dishonest Employees

Background: Forty percent of dental offices have been or will be embezzled by an employee.
Overview As employers, dentists need to prescreen applicants diligently, as well as take strong,
proactive roles in the monitoring of all business aspects of their practices.
Practice Implications: To make their offices embezzlement-proof, dentists need to take responsibility for both implementing and monitoring strict accounting and banking procedures. [Read more...]

High Tech Embezzlement Protection

Daniel McCann of the Dental Report Taking some simple steps with your practice management software can significantly reduce your risk of employee theft. From the middle of the article:

Limit Access to Data

“What happened in my office, says oral surgeon Lewis, “was that if patient paid $100, my front office manager would enter $80, write off the other $20, and attribute the lower fee to some sort of managed
care program cap. She was taking 20 percent off the top every day on managed care patients.”
But a commitment to use software Security features and monitor transactions daily can help dentists avoid such losses.