We orthodontists take a lot of things for granted. We did well in school and are doing well in life in general and this can give us a false sense of security and even a bit of undeserved arrogance when it comes to the inner workings of our practices. There are lots of questions we all think we know the answer to so I’ve decided to tackle  several here on OrthoPundit over the next few weeks. As usual, I’ve had to learn these lessons the hard way and sometimes more than once! For starters, how do you know for sure that you’re not being stolen from? Also, how do you know you are collecting the money you have earned – collecting from patients and insurance companies and medicaid?

These are just two examples of the questions that I and others have been asked in the past and thought I knew the answer to. Believing that your money is being collected and protected is not good enough. Not good enough by a long shot! To be clear, I’m speaking from experience here not hypothetically on both counts. So, how do you know?

Well, for the first question, I recommend you pay attention to the latest stories about thieves who were caught and then look at your own office personnel in that light. A great place to find stories about dental embezzlers is prosperident.com. Add this to the usual precautions like keeping incoming and outgoing money separate, signing every check yourself, running reports on write offs and adjustments, doing background checks on all new and current employees (if you haven’t done them) and looking at bank deposits and day sheets and you’ve got a pretty good start. Now you must realized that criminals are clever. Likely more clever than you and despite all your attempts they will find a way to get around your defenses. If you can admit this to yourself, read up on what David Harris, Chris Bentson and John McGill have to say about embezzlement and keep your eyes open then you’ll likely catch someone as quickly as you can reasonably expect to given the huge advantage they have over you. Having an outside accountant look at your books from time to time and ask questions is also not a bad idea. Prevention is unlikely when confronted with a determined criminal. Honestly, none of us KNOW that we aren’t being stolen from. Not with any kind of certainty, but I cannot advise you strongly enough to focus on the many resources and tactics out there to help protect yourself the best you can.

When it comes to making sure that you’re getting paid, there are many possible pitfalls that you might want to look out for between your money and your bank account. There is a good deal of crossover with this and the embezzling topic and thus the pairing. Simple questions are usually the most effective:

• Are contracts being signed?
• Are contracts being entered and started? (I learned about this one the hard way)
• Is the amount on the contract and the amount entered in the computer the same?
• Are the contracts being altered in any way? (I had a TC changing the down payment amount and pocketing the difference)
• Are your patients being billed appropriately?
• Are you having patients use auto-draft? (if not, you should!)
• Is your insurance and/or medicaid being filed? (I got nailed on this one – had an old office manager who stuffed all the contracts and insurance and medicaid paperwork in a desk drawer for months instead of entering them and then quit! I also had a front desk person in a satellite office who didn’t file insurance for YEARS and we lost a ton because it expired)
• Are you running account aging reports? How do you know they are accurate?
• Have you ever just taken the total number of case starts and multiplied it by your average monthly payment and down payment and checked those numbers against your monthly collection numbers and against the money that actually hits your bank account? (I got burned on this one BIG TIME – some people are so lazy that they would rather write off an account than follow procedure and get the money! And it’s harder to catch than you think if you’re not looking for it or they know HOW you look for it).

The list goes on and on and on and I’m sure you have many more of your own suggestions – maybe you can share them with us all? But the point is that it’s unwise to just accept what you’re told is going on in your practice even if you are running/looking at all the right reports, even if you trust the person in charge, even if you feel 100% confident (well, especially then). Looking at numbers and reports is great. Understanding how they are compiled and how the data is entered to generate the reports is better. Verifying that the raw data matches up with the reports, matches up with the deposit slips, matches up with the bank accounts and matches up with the number of starts and average financing you do is the best. Looking at the big picture with an eye on the details is your best bet to avoid big problems. I just wish someone had explained this to me 12 years ago when I started!