Doctors Only Webinar With Roz Fulmer and Steve Anderson.

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Presentation transcript:

Doctors Only Webinar With Roz Fulmer and Steve Anderson

Doctors Only Webinar With Roz Fulmer and Steve Anderson

What type of Schedule Template do you have? 3 Key Factors for FraudRationalizationOpportunityMotive

What type of Schedule Template do you have? Key Factors for Fraud Rationalization TEAM Member Stressed Out Financially “I’ll only steal this one time” “Nobody will ever know” “If I get caught, not much will happen” “It would only be my first time, so I would only get probation”

What type of Schedule Template do you have? Key Factors for Fraud Opportunity The practice has inadequate internal controls in place and THEY know it! Too Much Control is NOT a Good Thing They Know YOUR system better than YOU! Will YOU Prosecute?

What type of Schedule Template do you have? Key Factors for Fraud Motive Lack of Strong Moral Values Do YOU Lead by Example? “People do it all the time” is THEIR Motto! THEY have their OWN set of Rules

What type of Schedule Template do you have? Embezzlers! Who could it be? Why would they do it? -Someone you would not expect! -Resentful, Envious, Revenge -Empowerment to the Maximum -Borrowing vs Stealing

What type of Schedule Template do you have? Embezzlers! Their M O! -BLT (Believable, Lovable, Trustworthy! -No Past History -Any Age, Any Gender -Works all hours, no vacations -Has THE Authority -Knows the computer better than anyone

What type of Schedule Template do you have? EYES wide OPEN How will I know? Some KEY Facts Patient Complaints (“I already paid that balance”) Unexplained Adjustments and Credits given Sudden increase in an Employee Lifestyle Employee stays late frequently at the office Discovery that something does not look right on the books and they stumble trying to explain Shrinkage or Shortage of Petty Cash ONLY they do the mail, gets angry when another team member wants to help with mail Never out of the office for long periods of time

What type of Schedule Template do you have? “It Can’t Happen to Me!” Oh, Yes it Can! Oh, Yes it Can! What securities do you have in place ? Software, In-Office systems, at Your Bank, with Your Accountant, Internet and etc.

What type of Schedule Template do you have? Reduce your Risk PREVENTION- NOT REALLY! REDUCE the Possibility BE VISIBLE TAKE CHARGE IT’S YOUR PRACTICE!

What type of Schedule Template do you have? ASAP Action Plan Drop everything and get your PREVENTION SYSTEM CREATED! 1. Call your software support and only YOU should have total security clearance, no one else. 2. Sign in Sheet with First Initial/Last Name on a carbon sheet with tear-off slips. (HIPAA approved) 3. Know what reports to view daily, weekly and monthly and know what they are “telling” you in the reports. 4. Daily job duties, no one person doing it all. 5. No “Rubber” stamps or RX pad with your name and signature allowed in the office.

What type of Schedule Template do you have? ASAP Action Plan 6. Dr. only makes the Bank Deposits 7. Dr. only reviews all bank and credit card statements 8. Photocopy all checks daily, both personal and Insurance checks (put a post it note or put name of patient on the check) 9. Always do reference checks/background checks and exit interviews with team members. The Team needs to know that you are “involved” within the business part of the practice as well as the clinical. 10. Use a Background Screening Company when hiring new employees.

What type of Schedule Template do you have? What Reports??? D A V e Daily Asset Verification 1. Compare Practice Schedule to each charge that was done per patient for the day. 2. Review All Payments, Cash, Checks (in mail and over-the-counter) and Credit card Payments and Credits, plus Outside Financing (Care Credit, etc.) 3. Review All Credit Adjustments (none that say “credit adjustment) be specific with adjustment coding. 4. Review Audit Trail report for that day and question any “deletions” that occurred that day. 5. Review Daily Deposit and YOU take it to the Bank.

What type of Schedule Template do you have? What Reports??? THE DAILY, WEEKLY AND MONTHLY REPORTS 1. Provider Production Report = shows each person’s daily, weekly and monthly production. 2. Run Adjustment only report = shows each write-off or credit adjustment given to the account. 3. Run Accounts Receivable report (AR)= shows how much each patient owes on their accounts. Should not be more than one month’s production. 4. Run Insurance Aging Report = shows outstanding insurance money owed to the practice. Should not be more than two pages long for 45+ days. 5. Run Credit Balance report = shows how much the practice owes in refunds to patients. (DO NOT call the patients, wait for them to call). 6. Run the Audit Trail Report = shows any edits or deletions made to any account or to any part of the software system.

What type of Schedule Template do you have? Checklist Take control – you are in charge! Make sure that your actions are Honest! Review Daily, Weekly & Monthly Reports and understand what they are telling you. Dr. ONLY has ToP Security on all Software Programs Run the Audit Trail daily – Why were there deletions? No “Rubber” Signature Stamps in the office. More than one person opens and sorts the mail. More than one person enters payments (OTC and IM) Accounts Payable – Checkbook comparison All Bank and Credit Card Statements sent to YOUR home. Photocopy all checks daily Run Background and Reference Checks on Employees Hire an Honest CPA – Do a Background check on them.

References “Prevent Embezzlement in Your Office” American Dental Sales – Florida, Reprint from the McGill Advisory “Employee Embezzlement & Fraud in Dental Offices, author Donald P. Lewis, Jr., DDS. Federal Trade Commission – Protecting America’s Consumers, “What Employers Need to Know”, April 21, “Dental Embezzlement: “It Can’t Happen to Me!”, The Wealthy Dentist, Blog November 2 nd, 2007 by Jim DuMolin and Bryan Truitt

Done Losing My Assets! Don’t Expect What You Don’t Inspect YOURSELF!