Post on 15-Dec-2015
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 Fraud
RationalizationRationalization
OpportunityOpportunity
MotiveMotive
What type of
Schedule Template do you have?
Key Factors for Fraud
RationalizationRationalizationTEAM Member Stressed Out Financially TEAM Member Stressed Out Financially
““I’ll only steal this one time”I’ll only steal this one time”
““Nobody will ever know”Nobody will ever know”
““If I get caught, not much will happen”If I get caught, not much will happen”
““It would only be my first time, so I would It would only be my first time, so I would only get probation”only get probation”
What type of
Schedule Template do you have?
Key Factors for Fraud
OpportunityOpportunityThe practice has inadequate internal The practice has inadequate internal
controls in place and THEY know it!controls in place and THEY know it!
Too Much Control is NOT a Good ThingToo Much Control is NOT a Good Thing
They Know YOUR system better than YOU!They Know YOUR system better than YOU!
Will YOU Prosecute?Will YOU Prosecute?
What type of
Schedule Template do you have?
Key Factors for Fraud
MotiveMotiveLack of Strong Moral ValuesLack of Strong Moral Values
Do YOU Lead by Example?Do YOU Lead by Example?
““People do it all the time” is THEIR Motto!People do it all the time” is THEIR Motto!
THEY have their OWN set of RulesTHEY have their OWN set of Rules
What type of
Schedule Template do you have?
Embezzlers!
Who could it be?Who could it be?
Why would they do it? 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! 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 Verification1. 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)= showshow 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, 2010.
“Dental Embezzlement: “It Can’t Happen to Me!”, The Wealthy Dentist, Blog November 2nd, 2007 by
Jim DuMolin and Bryan Truitt
Done Losing My Assets!
Don’t Expect What You Don’t Inspect YOURSELF!
www.TotalPatientService.com
1-877-399-8677