Open Dental Forum

As we know, there is no way to completely prevent internal theft from ever possibly happening. This does not mean we shouldn't try to minimize the possible avenues for internal theft. I recently realized a way to steal that would be very hard to track and one way to make it harder. The scam goes like this, your front desk receives a cash payment for someone without insurance for $250. They print a receipt and hand it to the patient. Then they edit the payment to only show $150 and edit a filling from 3 years ago so that it costs $100 less. Your day sheet still balances, the patient account is still paid off, and it can be hard to figure out what happened. $100 doesn't make it into your account. The way to minimize this is to set the security for procedure editing to only allow 1 or 2 days to edit the procedure. We set for 2 days which allows staff to make corrections or other edits to a procedure, anything outside of this time frame must escalate to someone with permissions such as the Doctor. It was suggested that the back office be allowed to edit procedures for a longer time frame, but this would allow them to collude with the front to pull off the scam. The other change we made is that payments can only be edited by the financial coordinator. This means you only have to track one person instead of the whole front office (important if you have more than one at the front desk). Now the only way to pull off the scam is to short the payment at the time you receive it from the patient and edit their procedure from today to a lower amount. This is much more likely to be caught when handing the receipt to the patient and can't be "corrected" except by the doctor or financial coordinator.

Not being able to edit a payment also prevents back or future dating a payment after the fact. This works by receiving cash on 6/27/2012 and putting the payment date as 06/27/2002. The payment is 10 years in the past and the patient account shows that it is settled while the payment is not listed on the day sheet. The whole payment can now be pocketed. This does not prevent back or future dating at the time of checkout. Every once in a while you should check all your accounts for the day and look for these kinds of inconsistencies.

We trust our staff but there is nothing wrong with keeping the honest man honest and having things in place to catch a new or disgruntled employee who might decide it's OK to take more then their fair wage.

Yes, good advice....in our office no one can edit payments except the two doctors. If the staff makes a mistake, they have to alert us and then we have to log in and "correct" it. Annoying at times, but it should reduce the chance for fraud.

Yes, that definitely reduces chance of theft, but remember to watch out for shorted payments, adjusted procedures, or adjustments that are back and future dated.

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Besides the receipt book, I make the frontdesk girls put money/checks into an envelope with a sticky note with patient's name and date. Then the envelope gets placed into the safe. Credit card receipts are stapled to the receipt book. I will open the safe once a week and cross reference the amount in the envelope to the receipt book. Then input the payment myself.

As far as keeping patients accounts current, I would only be at most 1 week behind. Besides, the patient's balance gets written on their receipt anyhow.

I know this thread is a little old, but I am wondering what everyone does for secondary insurance and ortho payments? Both of these occur from a few weeks to a few months after the fact and if doing a lot of either then there are a lot of times you would have to make adjustments. I like keeping my lock date at 2 days, but that means I have to manually do all these. Do you just do them or do something else?

...and how often do you have to manually do them in your office?

Right now in our office the only person who can edit further than 2 days (other than the Dr's) is our financial coordinator which is myself. Ultimately you need to trust at least one person to manage finances or you need to do it yourself. Any time you delegate the finances there is a risk that the person doing it could embezzle from you. I have to much to lose to even think of embezzling other than to see ways in which it might be done and they try to come up with ways to make it harder to do for myself or anyone else.

That being said if there are ways to improve Open Dental's security in this regard, I'm happy to discuss them. Unfortunately you can't edit financials and not open the door for abuse at the same time.