Dental Products Report | April 2009
Products in Practice

Don’t be paranoid. Be protected

How practice management software can help prevent embezzlement.

by Thais Carter
 

It’s usually the best employees. The most loyal, most trusted employees.

Of all the news stories reporting on dental practice embezzlement, a common thread is the thieves started off as star employees. And every employer has the same quote, “I didn’t think it could happen to me.”

Surveys conducted in 2007 by the American Dental Association and TheWealthyDentist.com put the impact of embezzlement/theft anywhere from 17.5% to 59% of offices, respectively. The Levin Group reports 35% of surveyed dental offices have been knowingly embezzled, 17% more than once. However, in August of 2008, Henry Schein Practice Solutions (HSPS) conducted a focus group in which none of the attendees believed they had been embezzled from, something Steve Roberts, Director of Core Products & Electronic Services for DENTRIX (dentrix.com), knows is statistically inaccurate.

 EAGLESOFT TIPS & TRICKS

• Use the Deletion Report to look for items that have been deleted after the day has closed or items that have been deleted and not reentered correctly.

• The Adjustments by Type report should be reviewed for unusual adjustments—if someone is taking money and the treatment has not been deleted, there needs to be an adjustment so the patient’s account balance is correct. The office should have a standard protocol to approve adjustments.

• The Daily Production/Collection Summary report should equal to the penny the deposits put into the bank for the same time period. This ensures no one is pocketing cash payments.

• Detailed Production by Doctor is a valuable report for multiple provider offices. It takes less than five seconds to run and allows the user to see everything that has been assigned to the correct provider

This is no surprise to Cynthia Mattson, a dental CPA who provides accounting, tax and consulting services to dentists. In her experience, most dentists—clinically savvy, but lacking business training—are not concerned.

“The dental community, in general, is trusting and caring,” she said, “which makes them prime targets for embezzlement.”

According to the HSPS focus group, none of the attendees used any system security measures other than the standard Windows authentication, and none had ever attempted to search for embezzlement.

“Practice management system passwords were disabled or shared throughout the office, day-sheets were not run by entry-date through an automated process, audit reports were not being checked regularly…patient billing was not being monitored by the dentist,” Roberts said, and the list went on.

With the uncertain economic times, high rate of foreclosures, and ever-increasing layoffs, the circumstances are ripe for a good employee to get desperate. Is now the time to start interrogating your office manager, lock down files or panic? No. According to Mattson,  “concern should be ongoing, but paranoia should not reign.”

You don’t have to become the nutty boss who can’t trust his or her employees. In the modern dental practice, there are simple software solutions that can help you easily monitor the books so you can have peace of mind without creating a rift with valued staff members.

The dentist’s responsibility

Using practice management software to ease your paranoia only works if you know how to get the most out of the program. Too often, reports you learn to run during training are forgotten in the day-to-day running of the practice. Passwords put in place to prevent editing reports are never activated, perhaps saving time, but definitely putting the practice at higher risk.

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 Prevention 101
Simple steps to stop embezzlement early or prevent it altogether.

• Sign off on all cash adjustments each day and ask questions

• Copy each bank deposit receipt and attach to the day sheet

• Monitor bank statements and collection write-offs

• When possible, share office functions with more than one staff member

“Dentists can be shortsighted when looking at training versus production time,” Mattson said. “They think they can’t afford to take time off from seeing patients to learn.”

“Most dentists spend a significant amount of time training their staff to become proficient, even experts, in utilizing practice management software,” Roberts agreed. “That’s a key to efficiency. However, when the office staff knows the intricacies of practice management software and the dentist is indifferent, the risk of embezzlement increases significantly.”

Most of the major practice management systems available today have a variety of audit lists the dentist/employer needs to master and resources for both initial and ongoing training. PracticeWorks, exclusive maker of Kodak Dental Systems (kodakdental.com), offers a “Dentists Only” training course to bring doctors up to speed on the necessary functions of their software. HSPS offers extensive instruction for users of DENTRIX and Easy Dental (easydental.com), as does Patterson Dental for practices running EagleSoft (eaglesoft.net), the company’s practice management software. These courses should not be considered optional; a simple class can mean the difference between deterrence and victimization, between paranoid boss and proactive employer.

Traditional paper files may be what you’re used to, but they don’t provide the necessary leg up in the embezzlement battle.

“There are two key benefits to [practice management software]: prevention and evidence,” Roberts said. “When software is utilized properly, the systems associated with receivables management can be restricted to obviate the need to produce evidence of embezzlement later. When fraud is suspected, practice management software will quickly produce evidence of impropriety. Records cannot be manipulated without an evidence trail of the transactions in question being either edited or deleted.”

 DENTRIX TIPS & TRICKS

• Passwords can be used to prevent an unauthorized person from performing sensitive tasks such as changing information, deleting transactions and accessing financial information. When certain tasks are performed requiring security clearance, additional password entry is required for added security.

• Reporting capabilities include an entry data Day Sheet Report, Adjustment Summary Report and more importantly, an Audit Trail Report used to track who, what, when, where, why and how changes or deletions were made.

• The DENTRIX Timeclock is biometric enabled, preventing the manipulation of the work hours by any member of the staff.

• The DENTRIX credit card processing software is completely password protected, requiring overrides for credits. The reports may be easily reconciled against the daily deposit slip

   The dialogue with your staff

While the right software can prevent dentists from being paranoid, the onset of new oversights can be a difficult transition for the staff, even if everything is as it should be. Mattson suggests pinning it on the accountant to ensure the entire office team is on board.

“You can simply say that, ‘My accountant says I need to take more interest in how my business is run and she wants me to look at these reports,’ ” Mattson explained. “You can then hand the staff a list of the reports you plan to run.”
Roberts suggests helping employees take a larger perspective on security and its importance in the practice.

“Security goes beyond employees. What about cleaning crews, patients, maintenance people and others who

walk in and out of your doors everyday? Security safeguards, passwords, reporting and checks and balances when properly used help safeguard your business and your patients’ data,” he said. “As a business owner, you have a responsibility to your patients to ensure you do everything feasible to protect their data. This crucial conversation with your office manager or staff is not about a particular person—it is about sound business practices.”

The bottom line

There are some obvious benefits to practice management software you hear again and again: electronic charting, efficient scheduling and follow-up, math errors are eliminated and electronic records mean you never misplace a chart again. But now more than ever, this type of software is critical to helping doctors in large and small practices keep track of their books without the headache of becoming a super sleuth. More importantly, one or two simple reports mean you don’t lose your most valuable asset: your staff. 

(Clockwise from top) These screen captures show examples of some of the DENTRIX functions most helpful in spotting embezzlement, including the Audit Trail Report, and password security screens.      

Thais Carter is Editor-in-Chief of Dental Products Report. Contact her at tcarter@advanstar.com.