There has been a fair amount of speculation that with the severe recession, there will be an increase in fraud and internal thefts in businesses. While there is little evidence that this is the case – in fact, the opposite may be true – you should still take a look at your internal controls to insure that your revenue is ending up in the right place and that your records are correct.
Internal controls have several purposes, the most important of which is to insure that all revenue and expenses are recorded, and assets are recorded and placed where they belong. The essential concept is this: a separation of duties. The person who opens the mail and receives the checks is not the same person who enters payments into the bookkeeping system, and is not the same person who prepares the deposit. Otherwise, a payment could be missed – the check received but not credited to the patient – or, the check is received but the wrong account is credited. If a patient questions why they have not been credited for a payment, the practice has someplace to verify if the check was received and deposited.
Cash is another area to watch. Many practices have a small cash drawer for payments. The drawer should be counted at the beginning and end of the day, and tied to cash receipts. The basic formula is: starting cash balance, plus cash paid in, less any cash out, equals the ending cash balance. The actual count is the matched against the receipt books that record cash payments and any cash paid out.
Patient encounter forms should be pre-printed and pre-numbered. Even if a patient cancels, the form should be kept. This is a quick check – counting the number of encounters and compare to the number of patient visits that have been entered, and the number of patients who generated a charge that day. This can also be compared to the schedule if need be. This way you are making sure that a claim has been generated for every patient (or, any “no charge” is accounted for).
Much of this isn’t particularly complicated nor time-consuming. After tax season (no one probably has the time now), talk to your accountant about a review of your bookkeeping functions. Staff sometimes will feel that suddenly you don’t trust them – the sales message should be, and it is the truth, is about insuring that financial records are correct.