Donald P. Lewis, DDS, CFE

Did you know that 67% of dentists think they may be victims of financial fraud*? White-collar crime in the dental profession is widespread and growing, and current systems record transactions but cannot prevent dishonesty. Even simple mistakes can aggregate to thousands of dollars lost over time. The following prevention efforts are low cost or free, and can be implemented quickly to help you protect your practice.

1. This 30-minute audit can be performed weekly by the doctor:

• For each location and provider, pull 15 random patient charts from the past month's schedule.
• Confirm that treatment and payment were posted to the correct account.
• Ensure that payment was posted to the bank deposit.
• Confirm that bank receipts reflect the same total as the daily in-house deposit amount.
• When you're done, leave the charts at the front desk. Note that you are finished auditing and the charts can be filed. If you are paperless, notify the accountant and office manager that you are reviewing records regularly. This is a non-threatening way of alerting staff that you're involved, without detailing specifics.
• Have bank statements sent to your home address.

2. The following controls are essential to self-sustaining fraud prevention in the practice:

• Eliminate total financial control or knowledge by any one employee.
• Control adjustments, write-offs and refunds by reviewing each entry of the monthly adjustment report.
• Implement strict cash handling rules with separate receivables/payment personnel.
• Doctor(s) should be the only check signer(s).

3. Require that the accounting system and supervising employee provide regular reports:

• A numbered, daily audit trail should be presented to the doctor every day showing all transactions since the last report.
• At minimum, check the report for backdated entries, zero charges, charge adjustments and payment adjustments.
• Unexplained transactions should be discussed with the employee and your accountant.

Asking the right questions and instituting effective controls can be the best deterrent possible. If there is good reason to suspect embezzlement or fraud, contact your attorney immediately. Failing to prosecute could implicate you in concealing the commission of a crime. Honest employees will not feel accused, and will help protect the livelihood and integrity of the practice.

About Dr. Lewis

Donald P. Lewis, Jr. DDS, CFE is a Diplomate of the American Board of Oral and Maxillofacial Surgery and is currently in private practice in Cleveland, Ohio. He also has earned the designation of "Certified Fraud Examiner" (CFE) from the Board of Regents of the Association of Certified Fraud Examiners and is a respected lecturer on the subject of white-collar crime. Dr. Lewis has written numerous articles and books on the subject of Employee Embezzlement and Fraud. 

Cathy Jameson, PhD

Being "too busy" is a compliment to you. It means that you are doing a lot of things right and people are seeking your services. However, wouldn't you agree with me that being TOO busy can be a problem unto itself?

It is imperative that you control your growth or your growth will control you. The end result of being TOO busy can be overwhelming stress for the team, which can lead to burnout and dropout, compromised care of the patients or decreased profit.

Here are the seven steps to take to gain control of your "out of control" schedule. Each step will help by itself. A combination of one or more of these steps will make a significant difference.

1. Manage Your Schedule.  

2. Delegate.

3. Patient Financing Programs.

4. Fees. Even if you do lose some people from your practice for raised fees, you will have a better quality time with the patients who remain. You will have more time to do great new patient experiences and consultations and can do quadrant, half-mouth, arch or full-mouth cases, whether restorative or cosmetic. Your fees will be higher and will offset any losses of patients.

5. Associates. If the first four suggestions have been met or exceeded, you may need to consider an associate. This is a major decision and needs much consideration, planning and advice.

6. Refer.

7. Insurance. If you are too busy, and if you are on any managed care programs, this may be the time to decide whether or not you wish to remain a provider. If you choose to make the decision to drop insurance, let me strongly recommend that you do so with care and planning. If this step is executed poorly or without a strategic plan, the results can be disastrous. Done well, however, it can be successful. You must be clear on your vision and on your goals. You must be confident. You must be an excellent manager and leader.

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