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Internal controls: Plugging the hole in your bucket (Proceedings)

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Aug 01, 2010

How Many Services Rendered In Your Practice Are Not Accounted For?

A. Outpatient Services

Fecal Exam

Heartworm check

Injections

Nail Trim

Other

B. In-Patient Services

Surgical cases

      Suture material

      Anesthesia time

      Hospitalization

      Extra materials used

Medical cases

      Injections

      Fluid therapy

      I.V. catheters

      Radiographs

      Laboratory procedures

      Outpatient procedures

Vaccinations

Heartworm check

The Cost To Your Practice In Lost Revenue

A. Outpatient services - $ ________

B. In-patient services - $ ________

      Surgical cases - $ ________

      Medical cases - $ ________

Effect On Your Bottom Line

A. Represents "true profits"

B. High Gross – Low Net

Causes Of Ineffective Charging And Lack Of Effective Internal Controls

A. Practitioners are too busy

B. Receptionist-oriented problems

      Lack of concern

      Lack of motivation

      Lack of training

4. Responsibility "thrown upon them"

      C. Ineffective management

      D. Inefficient or confusing fee schedule and receipting system

      E. Intentionally not rendering services

      F. Intentional "give-aways"

How To Implement Effective Internal Controls And Prevent Client Give-Aways

A. Out-patient services

1. Itemized client statement

2. Have receptionist circle services requested by client

3. Receptionist should be required to review medical record

      Update preventative procedures

      Simple and efficient method of record keeping

4. Exam room check-off form

      Use of exam room technician

5. Practitioner to check through circled procedures and check-off any additional services rendered

Receptionist to post charges for ALL services rendered

B. In-patient procedures

1. Surgical procedures

a. Operating room usage form

      To be completed by surgical technician

b. Common sense (ie. If there is an operating room charge, there has to be an anesthesia charge)

c. One person in charge of posting all surgical fees

d. Charge for surgeon's time

e. Charge for anesthesia time

2. Medical procedures

a. In-hospital tracking form

1. Must have accurate medical record system

2. One person in charge of reviewing chart and posting all charges

3. Common sense (ie. I.V. catheters for heartworm treatments; "bandages," etc.)