Eyeworld

20 Ophthalmology Business • March 2016 Sometimes there isn't sufficient staff for such a process, so another process Mr. Dawson will advocate is to limit the number of people (1 or perhaps 2) handling and document- ing payments. Although this may not prevent fraud, it does make it easy to narrow the circle of blame. 5. Out of sight, out of mind. If employees know they may be visually monitored, it will help cut down the risk of theft, Ms. Eaton said. Arrange the office in such a way that adminis- trators or doctors have a good line of sight on employees. 6. Use electronic health re- cords (EHRs) to your advantage. For example, to cut down on the altering of patient records to delete patient encounters or payments (because an employee has potentially pocketed such payments), use the audit func- tion of your EHR software, Ms. Boxe advised. Unique log-in credentials for each EHR user can help you track who made certain changes. "It is crucial to communicate to staff how the audit function works by storing a record of each action within the software to de- ter data alteration," she said. Although the bells and whistles associated with EHRs can sound im- pressive, you'll ultimately have to rely on old-fashioned monitoring when it comes to curbing employee theft. "Nothing replaces prevention- based measures that are based on awareness. If the doctors and practice adminis- trators raise their level and that of the staff of fraud awareness through peri- odic training, half the battle is won," Mr. Dawson said. OB Reference 1. McClure D, et al. Theft in group practices costs billions of dollars annually. MGMA Connexion. Sept. 2010. Contact information Boxe: jboxe@irisinternationalconsulting.com Dawson: steve@dawsonforensics.com Eaton: jean@informationmanagers.ca 1 preventive control that exists is to raise the perception of detection. If a potential fraudster believes they have a good chance of getting caught, they are less likely to steal," Mr. Dawson said. This is why he advises periodic training to raise awareness about fraud that will detail what the office does to address the risks associated with fraud. He also supports having a fraud policy that details what fraud is and a fraud reporting policy. Such policies can be documents that employees must sign once they review them. "The contents of the policy should be reviewed at least annually, which in and of itself raises the level of fraud awareness for staff," he said. 4. Separate financial-related duties. There should be more than one person handling financial-related tasks as a way to maintain internal control. What Mr. Dawson usually advocates is as follows: a. One employee logs cash or patients' accounts receivable payments for the day's receipts. b. A different employee posts to the patients' accounts receivables. c. If there is adequate staff, the deposit slip is prepared by a third em- ployee. d. The amount posted to patients' accounts receivables should be com- pared to the amount received for the day by the first 2 employees. It's surprising to find the number of businesses that have put someone in a financial accountability position who has a criminal background related to financial crimes, Mr. Dawson said. However, he added, "I want to do everything to change the mindset that if we have good people, we won't have fraud," he said. In fact, the vast ma- jority of investigations he's performed have found that the person commit- ting fraud is a decent person who is under financial pressure, can rational- ize the theft (thinking that they will eventually pay the money back), or has the opportunity—when the business has few internal controls. In fact, a common thought process used by forensic accountants and audi- tors is the 10-10-80 rule, which states that 10% of employees will steal under any circumstance, 10% will never steal, and 80% will steal under the right cir- cumstances. 1 2. Track inventory. Consider all tangible items at the practice, includ- ing frames, contact lenses, pharmaceu- ticals, and accessories, and track them using an inventory management sys- tem, Ms. Boxe suggested. Make sure to conduct a physical inventory regularly and compare the results with invento- ry management. Keep tangibles under lock and key, Ms. Eaton recommended. 3. Let employees know you are concerned about fraud. "The number continued from page 19 " A common thought process used by forensic accountants and auditors is the 10-10-80 rule, which states that 10% of employees will steal under any circumstance, 10% will never steal, and 80% will steal under the right circumstances. "

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