Practice
Management
By Pat O'Sullivan, President
Internal Controls Critical Now
More than ever before, Internal Controls in our businesses are so critical for assurance of compliance, regulatory, financial and human resource management. One of the biggest mistakes a medical practice makes when the physician starts out is to think, “we’re only three people, we don’t need a lot of policies and procedures…we’re not IBM!”. Then all of a sudden, there are four people, two physicians, a nurse, a supervisor and suddenly someone embezzles money, has a personal leave, or is rude to a patient and they leave the practice. These are all realistic occurrences in a practice every day. The policies and procedures/internal controls are meant to protect the patient, employee, the physicians and ultimately, the success of the business.
Imagine the damage that could be done with a signature stamp with prescriptions, checks, disability forms, or other secure documents in a practice? Here is a list of items to consider when reviewing “internal control opportunities” in our practice:
- Cash drawer
- Daily balancing
- Electronic scanning deposits
- Daily posting of payments
- Totals should balance everywhere
- Charges are they Readable?
- Diagnoses Readable are they Readable?
- Coding
- Documentation
- Seeing the patients without a medical record (lost somewhere)
- Hiring staff without a background check
- Hiring without checking references thoroughly
- Time clocks and payroll accuracy
We have a flow chart for internal control opportunities which could be used as a checklist for the practice. For instance, concentrate on one area at a time and tear it apart to evaluate if each of the tasks is detailed and assures compliance on the part of the employee and the physician. In other words, at the front desk, have we protected ourselves against fraud by requiring a photo identification from the patients?
These are just a few ideas but it is an ongoing education and review of the practice policies which will reduce the risk of our medical practices, whether large or small.
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