embezzlement

[Robert_dds]

Is there a way that I can allow my assistant to input check payment in account without able to input writeoff?
I called OD the other day, and one of the rep. said that it's not possible. There should be a feature where assistant can input payment, but unable to delete claim and unable to input writeoff.

[Yorek]

Here are two suggestions to improve security.
The "Deposit" is a second way to confirm checks have actually been deposited once entered in OD.

1) in Edit Deposit Slip"
include another Box to show : Total payments perhaps under Date.
This is different from "check made" and this $dollar value would be since the last deposit as some office may not make daily deposits.

This dollar Value should equal the Total Amount of the Deposit in the box under it, or something has been omitted.. Stolen?

2) Sometimes by innocent omission or by deliberate criminal intent
a check can be left out of the deposit module.

To identify this.. add a separate section in "Edit Deposit Slip" that shows insurance checks that have been omitted from "Create Check".
Checks in this section could not be deleted by a limited user only corrected and added to the deposit.

Then, to correct this omission, (if innocent), one would only have to click on the omitted check(s) which link back to that patient's account and easily 'make check'. It saves the aggravation of having to first close the deposit, find the patient acct, click down to Create Check then go back to deposit and start all over... Whew, long way around. (this happens to us more than we'd like it to.)

So, this is just an added layer of security and convenience and may also be a deterrent to the criminal mind showing that this office takes embezzlement seriously.

Thanks.

PS, We think it would be a good idea to add a check counter in Edit Deposit slip.
This could be another Box under (deposit) Amount showing the total # of checks in that deposit.

This would help confirm the accuracy of the deposit (especially when there are many checks).
and security, as some doctors know how many checks came in on any particular day.

Many apologies for the lengthy post.

[jordansparks]

You're talking about an insurance payment, right? I've never really seen a way that someone could embezzle from the insurance payment window. If you can come up with a scenario, then we can go from there. If you would rather send me the scenario by private message so that it's not made public, then that would be fine.

[Robert_dds]

You're talking about an insurance payment, right? I've never really seen a way that someone could embezzle from the insurance payment window. If you can come up with a scenario, then we can go from there. If you would rather send me the scenario by private message so that it's not made public, then that would be fine.

Jordan,
Assistant can open up the insurance check, then go into payment, input the total of the check as write off. This will never show up on deposit slip and able to zero out patient's balance. She can take that check and deposit it into her account. That's what happened to me. It's a good idea if you can 1) Make it so assistant can input payment but unable to input writeoff unless given permission. 2) Unable to delete claim.

[Rickliftig]

I could see a solution as simple as having the daily sheet not only print receipts and charges, but also a section for write-offs and $$$ adjustments of any type. It would be pretty obvious upon review.

[Robert_dds]

Yes, but we should not allow staff to do write off unless there's permission. Therefore, there should be an option in the security portion for us to allow or don't allow staff to do eob's write off.

[jordansparks]

OK, just added it as request #935.

p.s. I'm hoping that the request list will be searchable by request # by later today.

[jordansparks]

You can now search by request id #

[cneelley]

Interesting subject. Sorry to here that an assistant was able to do that to you, and your business. I've been in this business for over 30 years and it has always been a big problem in our industry.

First, it seems kind of silly to put in a request to fix, or at least address, a problem of this magnitude on such a long list. #900 and something! I know that Dr. Sparks and his crew are busy, but the request list is getting ridiculously long.

I don't know if the problem of embezelment can ever be fixed, but we have to keep trying.

It seems to me that the best way to prevent embezelement is by having a multi-step multi-handed method to get the final entries. One person gets mail, opens it, counts the insurance checks, and makes a note. Another person enters the insurance checks. Writeoffs must be handled by the most trusted of all. To allow one person to do all of this is flirting with disaster, I don't care how good your software may be.

Opendental has a write off report that is very good, and should be checked daily.

I am sure that there are a multitude of "systems" out there to address this problem. Large corporations spend large dollars to do everything possible to prevent embezelment. I think it takes a well thought out procedure list plus adequate software and the unthinkable, the owner of the business actually taking the time to check and double check.

Good Luck

[jordansparks]

I fully expect the request list to get much much longer. As it does, we will be working to make it easier to find similar requests. Requests don't get lost in the shuffle. For example, if we decide to enhance security, we do some careful searches on terms like "security" and "permission" to make sure we consider all requests that might apply before we begin work. It may seem overwhelming to some people, but it's not to us. It is instead a very useful tool.

Yes, making sure multiple people are required for a sensitive task does greatly reduce risk.

[cheroxy]

Opendental has a write off report that is very good, and should be checked daily.

How do you verify that report? It seems too easy for someone to pocket some cash paid by a pt to finish their balance and then do an insurance write off. The only way apparent to me to avoid that would be to check each insurance adjustment against the statements that come in. That would take a very long time. Is there a better way?

[DavidWolf]

As a start to help check for this behavior.....

How about a simple query that compares the fee charged to the writeoff and reports writeoffs that are equal to the amount charged or above the normal percentage normally written off.

For the person this happened to this would at the least allow you to find out how much was stolen.

[jordansparks]

Also just curious why a bank would accept a such a second party check. It's not made out to the staff person, so why would they allow a deposit?

[drtech]

i think he means cash transactions, not checks

[cneelley]

I know of dentists that have been ripped off by staff members who set up business bank accounts and just made the dentists insurance checks deposits into that account. The dentist didn't have a clue that the other account even existed.

People are very smart, very resourceful, always able to get around most any system that is in place. Checks and balances are necessary, and they must be carried out to the letter, every day, to prevent bad things from happening. Cheroxy was wondering if there was a better, I wonder if she meant, easier, way to do things. My answer is that it takes work, concern, being responsible, and looking. So, it's not easy.

In my case, I decided to get in the middle. I can post checks, make deposits, call insurance companies, etc., and even though I do very little of that, I do know how to do it and I can do it. That keeps me up to date, and if things look strange, I can easily recognize it.

I have a security camera in the front desk area. Like I said, there are numerous systems out there, but anything can be beat if nobody is looking.

Dr. Neelley

[cheroxy]

I did mean cash, thanks. I could see the following scenario pretty easily happening and easy to miss...

Patient has 100 balance that they owe
They come in and pay it with cash
Staff pockets the cash and enters a 100 insurance write off to clear the account
Dr. doesn't verify all the statements from insurance because it would take hours and the error slips by unnoticed....

[cheroxy]

Maybe have the person who enters insurance adjustments do it only on a specific day or something, then track that time so if anything happens outside of that window it would be an obvious red flag. Just one thought.

[DavidWolf]

You can also set the insurance edit security limit to 1 day.
Which means that only if the cash payment was made on the same day the insurance payment came in would the adjustment be allowed.

[wrhiltz]

Here are a few red flags which are consistent with employee perpetrated fraud. Most dental programs will capture sufficient information to allow you to query and report for these anomalies. You may have to export the data to Excel or some other software for analysis.

(i) InsCo payments recorded 1 to 3 days after treatment.

(ii) Cash payments recorded on account 1 to 48 hours after the appointment has ended.

(iii) Cash to Revenue ratio shows a negative trend over time (take the pervious 12 months and calculate cash as a percentage of total revenue. Then plot each month on a graph and run a regression line thorough the points. The percentage of cash collected will vary depending on your practice characteristics; the average should be in the 2 to 4% range (but I caution you as this is very practice specific) The idea is to look for trends in transaction types over time.

(iv) Transactions posted on (i) federal or state holidays, (ii) during office vacation closures and (iii) after hours – for example, someone coming into the office at 5:00 AM each day.

Other clues (staff behavior) :

(i) comes in early and leaves late;

(Iii) controls everything to do with financial transactions; is the nexus of the office communication

(iv) never takes vacation; resist change in financial policies, is against software change, meddles in other peoples business

If you have any concerns about embezzlement or just have questions, please fee free to contact me privately.

William Hiltz
http://www.prosperident.com
Specializing in Fraud Prevention, Detection and Remediation for Dentists

[cheroxy]

Re: my earlier post and your first item. Do you just look at the report for the insurance payments and know if tx was recently done rather than 2-3 weeks ago or however long it takes for your insurance check to arrive? That would be pretty hard for me.