In part one, we explored the most common way an employee can embezzle from a practice. That method was to simply not record an appointment and keep the payment. The second most common method of embezzlement involves the inappropriate use of adjustments.
When a patient is checked out, it is very easy for an employee to lower the amount owed by entering a simple adjustment. This can be done after the patient has been checked out and a walk-out statement printed. If the patient has paid any cash portion, the adjustment can be for part or all of the cash and the employee will pocket that amount. Some employees have been so bold as to offer the patients an unauthorized cash discount to encourage the patients to pay in cash.
Even if there is no cash payment involved, and the patient pays with a check, then the check may be held for later use. The employee can substitute that check on another day when there is a comparable amount of cash. The employee simply keeps the cash and the check offsets the shortage.
How can the doctor use dental software prevent this activity? Most dental software programs offer an adjustment report. In the ACE program, simply pull down the report menu and click on adjustment report. Enter the date range (it will default to today's date). All adjustments made for that date range will appear on the report. The doctor should view this report at least weekly if not daily. By watching that report over time, the doctor can get an idea of what is normal and what is abnormal activity on that report.
Some dental software programs offer additional security measures. In the ACE program, we can set permissions to determine who can and cannot enter adjustments. If you log in as administrator, and select a given staff person, you are presented with a list of permissions. If you uncheck the Enter Adjustments box, the staff person cannot enter adjustments. They will then have to askanother employee who has this permission to enter the necessary adjustments. This can be an enormous deterrence to any unscrupulous use of adjustments.