North Texas Dentistry Volume 8 Issue 3 2018 ISSUE 3 DE - Page 40

fraud alert Reduce Fraud in Your Office by Richard V. Lyschik, DDS, FAGD, CFE We summarized in our last article that no practice is 100% safe from fraud and that you have to make ongoing correc- tions to continue to reduce fraud incidents. We are strong advocates of an employee manual that promotes an anti- fraud culture in your practice. You should make it clear to your staff that you will pursue all fraud cases vigorously, taking appropriate disciplinary, and when necessary, legal actions when justified! There are three types of fraud that occur in a dental prac- tice: Corruption, Asset Misappropriation, and Fraudulent Statements. The practice owner, the spouse, a staff mem- ber, along with numerous more outside services, have all been discovered committing fraud to the detriment of many dental practices. When it comes to fraud incidence and occurrence, dental practices are no different than other businesses of similar size. Quite shockingly, the smaller the business, the greater is the chance of fraud, and larger is the proportion of loss to the practice from fraud. Over 40% of businesses do not recover after a major fraud incident! In a dental practice, a fraud incident becomes apparent when it affects over 5% of the practice’s gross income. Much fraud remains undiscovered because the suspect employee keeps the theft under that threshold amount. But over time, sheer greed, mixed with confidence that the Doctor won’t notice, ultimately triggers suspicion. The longer a fraud is allowed to continue, the greater is the median loss to the practice. Compounded by the disbelief that it may be someone the doctor has trusted, the fraud discovery is often more painful than the loss of money! We have often heard: “But she has been with the practice for many years!” and “The family goes to our church!” Our largest discovery to date has been over $700,000 stolen by one employee, over a twelve year period, in a Texas dental office. And as we have recently read in the ADA News, when Medicaid fraud has been uncovered, settlements are often in the millions of dollars! Our team assists with guidance to gather evidence if there is suspicion of fraud in the dental practice. The goals of a fraud investigation include: * Prevent further loss or exposure to risk * Determine if there is any ongoing conduct of concern * Secure evidence necessary for disciplinary action * Minimize and recover losses * Review the reasons for the incident * Investigate measures to prevent a recurrence * Determine actions needed to strengthen future responses to fraud TIPS While investigating potential fraud: Avoid tipping off the fraudster! When investigation details are leaked, concealment, and destruction of evidence typically occur at a faster rate. Close the circle slowly, review and print data, interview other staff, patients, etc. and finally include the fraudster. If computer data is involved, change those passwords! Remove the fraudster once the 䁡ٔѥѼ)ȁٕѥѥIѥѡɅѥ́Ёѕ)ɅѥͼЁ́ЁѼѡݥѠ) ͥȁ܁ɍЁͥх%Ё́ѕɵ)ѡЁɵɕɅѼ܁ɍЁݥɔѡ)Ȱѡͥȁѥ她ѡѡɥѥ́Ѽѕɵ)ݡѡȁ܁ɍЁͽ͡ձѥєѡ)ѕ٥ܸ(9=IQ QaL9Q%MQIdܹѡѕ͑ѥ乍