Improvement

Cash Control: How Do You Handle Cash In The Office?

A Clear Policy and Audit Process Is a Must to Avoid Theft

Mechanisms for controlling and monitoring the handling of payments are a necessary duty for the owner/manager of any small business that receives cash. Many physician practices suffer from poor controls and this weakness is often observed and exploited by employees. It is unfortunate but true that some employees who are not under visual surveillance may begin to day dream about how they could spend the cash passing thru their hands. They may also be betting that you have no way to figure out if cash is missing.

Are controls worth the trouble? Imagine a devious employee pockets as few as two copays per day averaging $35… by the end of the year the total amount embezzled could be in excess of $8500 ($35 x 250 days). Unfortunately, stories about theft of cash from medical offices are all too common. Usually the cash is never recovered and the employee is not prosecuted. You can avoid most theft by investing a very minimal amount of time and effort.

There are many ways to set up a system that will help eliminate the leaking cash syndrome. One key element is to hold specific employees accountable, that is, they are responsible for adding cash up at the end of the day. Another is to occasionally announce surprise audits of cash received. It is important that your staff with access to cash know that these audits have occurred and will continue. A comparison of your list of patients seen for the day to the encounter data for the day is a good start. Receipts for the day should match the receipts recorded on the encounter. This may be all it takes to discourage amateur thieves. You could do the audit once a month or even less just often enough to drive home the idea that you are watching. With new employees, you should do an audit or two early on so they are aware of the controls you have developed.

If necessary, increasing the depth of the audit and the demands on patients and staff may required. For example, why not have staff be accountable for collecting balances due and copays. Many offices have moved to a no excuses policy for collection of copays and payments on past due balances. This kind of policy allows audits of encounter forms to be even more reliable as a deterrent to theft. All you need to do is to add up the cash that was supposed to be collected versus the actual. If there is a shortfall, the person responsible for collecting cash would need to explain and then be retrained until they completely understand your policies.