Practice Management Alert

Be ready, because some employees can't resist dipping into the till

Having a few simple procedures in place could prevent your practice from falling prey to unscrupulous employees intent on stealing right from under your nose.
 
If you stand silent and install no  embezzlement-fighting policies, the office could be getting ripped off as you read. Embezzlement in physician offices was once a dirty little secret that no one talked about. But as the nature of payments has changed, there's more opportunity than ever before for employees to steal from a medical office. 
 
Of particular concern, of course, is all that cash generated by medical practices. -Cash co-pays are going higher and higher, increasing the doctor's exposure to financial loss,- says Barbara Cobuzzi, president of CRN Healthcare Solutions, of Shrewsbury, NJ. 

It's Fallacious to Focus Only on Front-Office Staff

The front desk where staff collect co-pays deserves special oversight, but there are other areas, such as claims processing, that are susceptible to an attack of the sticky fingers.  
 
-A practice manager was -upcoding- E/M services by one level on insurance claims, sending the claims and pocketing the difference,- says Catherine Brink, president of HealthCare Resource Management in Spring Lake, N.J.   The correct level of E/M was on the encounter form and entered in the computer system, enabling him to pocket the difference. 
 
Benefits and employment perks are also fair game for office theft.    
 
-I have seen cases of trusted office workers giving themselves benefits, everything from vacation days and year-end bonuses to participation in a 401k plan they were not entitled to,- says Maria Rodriguez, a partner with the law firm of Silver & Freedman in Los Angeles
 
Rodriguez warns that it's not just employees who are in financial difficulty who steal from a medical office. 
 
-Sometimes people have an attitude of entitlement,- she says. -You really need to get to know your employees.-

Take These Practical Steps to Prevent Embezzlement

Medical practices should institute several procedures to thwart the would-be thief on the payroll:
 
 - Create a system of checks and balances. Multiple people should be handling and checking the cash. The same system should apply also to patient checks and inventory.   For example, for the billing department, different people should open mail, post payments, make out deposit tickets, and make the actual deposit at the bank.

 - Ensure that your accounting system proves out all deposits in the computer system so that all deposits posted should equal all payments.

 - Review comparative financial data to look for any glaring problems, Rodriguez says. Use a simple tool such as a spreadsheet that summarizes the practice's accounting. Do this on a regular basis to see if your numbers -add up.- Employees will be less likely to embezzle if they know they will be spot-checked.

 - Enter all manufacturer incentives into the practice's inventory system. Cobuzzi cautions practices that keep inventories of high-value products on hand -- such as those with a heavy cosmetic emphasis -- to keep a close eye on inventories.

 - Encourage staff to take time off. -Everyone should be required to take a vacation,- Cobuzzi says.   
 
-Then you can figure out if there's a problem.  Also, if a person doesn't want to take a vacation, that is a sign there may be a problem -- they get greedy and don't want to be away from the money.-