To defend against fraud, physicians must get involved in the day-to-day operations of the office, at least in a limited way. To protect yourself, put the following financial controls in place:
Sign all your checks yourself. Keep the office manager off the signature card and don't use a signature stamp. Don't sign a check unless there's an original invoice that's been marked "paid" so that it can't be paid a second time-either accidentally or deliberately. Check to make sure the invoice amount seems reasonable. For example, if you usually spend $200 per month on office supplies and suddenly you have an invoice for $1,000, question that. Be on the lookout for new suppliers, too.
Open or download bank statements yourself. You may not have time to reconcile the bank statement every month, but at the very least, you should be the one to open the envelope. Scan the bank statement and look to see that the ins and outs of what's happened in that month seem right to you. Look through all the canceled checks. Does it look like your signature? Does it look like the payees are people you would expect to have paid?
Okay all changes to payroll. Ideally, doctors should be the only people in the practice with the authority to add an employee to the payroll or change wage amounts. If it's necessary to allow an employee to change the rates, make sure your payroll company issues a report of the change directly to you. Also, make sure you review all overtime. It’s very easy to steal by padding hours.
Require written annual competitive bids from your vendors. Unless you get bids for products that you use in volume, you could be overpaying. Requiring written bids prevents employees from entering into fraudulent, long-term partnerships with a vendor. I know of a case in which a practice employee paired up with a member of the vendor's finance staff to overcharge the physician and split the profits. N
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