Friday, September 14, 2012


It is official. I have purchased 100% of my practice. I have been making pretty much all the decision around here for the last couple of years (my dad did a good job giving me the reins little by little), but the weight of the whole thing seems heavy. Nothing has changed, but knowing that it is all mine has been shockingly burdensome. I have worked so hard for this. I have been chasing after this dream and now that I finally have it, it just is weird.

One of the gals I run with owns a retail store. She recently let an employee go because he was stealing cash. He is 65 years old and had been with the company for 36 years. It is a family-run store and he started when my friend’s father was the owner. He has been to all the weddings, baptisms and BBQs the family had. He was part of the family. Wow. Does this make you think?

I started to think about tightening up my ship, money-wise. This may sound weird, but I don't look at a day sheet. I look at the schedule in the morning and make a mental note of how it looks. I can judge the production pretty well. I know that if everyone comes today this will be a really good day. Some days, I hope someone comes in with an emergency because nothing productive is going on. Then I realized that production doesn't mean as much as collection. So, this week, I asked for a daily sheet that has production and collections on it.

This sheet is absolutely meaningless. Let’s just say on Tuesday the office produced $1,000. Great. How much did we collect? $240. Then the next day, we produced $1,000 and collected $3,800. I found tracking collections is very difficult. We are a fee-for-service office and we take traditional insurances (80/20), but still so much depends on insurance checks. We might do a crown one day and not get paid for a couple of weeks. So, what good is looking at the collections?

While doing all this, I started to think about something. I get the audit sheet once a month. This is a list of all of the folks that owe us money. Eighty percent of them are outstanding insurance. That means that if someone had a crown done, we charged them half knowing that they have insurance. The insurance check hasn't come in yet, so they get put on this list. Twelve percent of these people we have arrangements with. Someone might not have been able to afford the procedure, but we did it anyway knowing that collecting would not be an issue. And about 5% or so are people that really owe us money. There are 30-, 60- and 90-day columns. On this list, my staff notes what is going on with each person. If an amount is over say, $500, I will look at this line item. If I see she has an “INS” by the name, we are just waiting for insurance. I know she is on it. If there is a “DLQ” by the name, they have been sent to collections.

Then there are the ones that I know have moved because they have lost their job. They foreclosed on their house. They had to sell the car to buy a van they could live in. And we have been hounding them for $178 for 14 months. I will say just write this off. There comes a time when it just isn't worth it. The man-hours, the stamps, the phone calls, the letters. For $53, how long do you hold on to this stuff? I mean, they were paying $5 a month for 2 and a half years and then the $5 stopped coming. Just write it off.

The blog was not going to be about this stuff. When I realized I am now 100% owner, I started to think. My person up there, the one collecting the money, the one I trust whole-heartedly, could really be robbing me blind and I wouldn't know it. There are checks and balances here, but there are still holes the size of California in our systems.

I started to think how she could be doing it. She could be doing it collections. There really is no way to check. Say Mr. Bill comes in and gets a crown. The day of prep he pays $500. The insurance request goes out. He owes us $700. The audit sheet shows Mr. Bill owes $700 with “INS” next to it. Let’s say the insurance pays $500. The next month, the audit sheet shows Mr. Bill owes $200, and there is a check mark next to it meaning she is on it. Mr. Bill comes in and pays $200 in cash. She zeroes his account out and puts $200 cash in her pocket. No one knows. How do you prevent this? Cameras?

I have already told you that I am a NOT a micromanager. I am pretty happy that I am looking at the day sheet. That was a big step. But me going further? Ughhh. As I write this, I think there must be a "write off" line item. I think when she writes things off and hits "enter," it goes to a place on EagleSoft and this could something I could check.

I can't collect myself. I have to have someone do it. I have to trust. I have to look at the sheets, but I have to trust in the person putting the sheets together. I don't know. I feel like the woman that does my collecting is part of my family. She has been here about 13 years. Hmm. This is starting to sound like my running friend’s story.

I trust my person up there, but I know everyone who gets money embezzled feels the same way. My assistant tells me that this person is the last person who would steal from me. But these are famous last words. I am not accusing anyone. I am not even suggesting that it is happening here. I am saying that it does happen and it is usually people that you trust the most and you let your guard down.

What do you guys think? Do you have checks and balances? Do you put your head in the sand a bit? Or are you the Gestapo? Let me know. Then have a great weekend.

I am running 22 miles tomorrow morning, then sitting on the couch and watching the Gators play Tennessee. Wish me luck on both.



Dr. Erich Herber said...

Congratulations on taking over the reins. Sounds like your head is in the game, and it's working like it should. Everyone is different in how they handle the books. You'll find your way, and it will be the best way for you to do it for your office. Much luck to you - and wow - great job with running!

Jeff said...

great ideas!

Anonymous said...

The ADA has a stat that says something like 30% of dental practices get embezzled. Makes you have to look and stay on top of this stuff

Good luck


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