Fraud Prevention Starts at the Top

Avoid an environment where fraud is tolerated by following these suggestions.

 It seems as though fraud is everywhere today–you hear about mail fraud schemes, phone scams, and Internet hoaxes that bilk thousands if not millions of dollars from innocent victims all over the world. Chances are good that you know someone who’s lost some of their hard-earned money to one of these schemes.

Sadly, fraudulent activity happens just as often in dental offices across America. It happened in my office, and I’m the one who discovered it. It was so traumatic for all of us that it became my personal mission to find a way to keep fraud from happening in as many dental offices as I can.

Although there is no foolproof method to completely prevent embezzlement or misuse of funds, there are steps that can be taken to deter fraudulent activity. First and foremost, if your gut tells you that something doesn’t feel right, listen to your gut. Think of fraud as tooth decay. Time will not heal it and it will only get worse.

Second, if you as the owner want to counteract fraud, you need to start from the top. Create a standard of conduct for the practice team, and then be the example of that standard. This standard should include everything from insurance to scheduling, to presenting treatment, and of course, how to handle all money. If the doctor takes money out of petty cash for personal use, this sets the example as acceptable behavior. If the doctor allows a buildup to be charged as a filling because this helps the patient get paid through insurance, the doctor is setting the standard of conduct.

If an employee perceives that working the system or skirting the rules is acceptable, then the employer is allowing the fraudulent activity. Cheating is cheating and should never be tolerated. Cheating in any way is not acceptable and anyone caught doing anything against the standards should suffer automatic consequences.

Finally, know who you’re hiring by checking references. We often see this process delegated to a team member in the office. But our rule of thumb is whoever signs the checks calls all references and speaks to the person who signed the checks at the previous office. We think it’s important to make it a habit of talking employer to employer.

There are a few behavioral habits that are well documented as good practices for fraud prevention, and I believe these should be followed as well:

  1. Everyone in the office with any control over finances must take mandatory vacation time out of the office so that other staff are required to get their eyes and hands into that controller’s business.
  2. Whoever balances the daily deposit should not be the person to take the deposit to the bank.
  3. The office should make it a priority to reconcile bank and credit card statements monthly.
  4. Periodically hire an outside accountant or examiner to drop in with little or no notice to inspect the books.
  5. Familiarize yourself with the Dentrix Audit Trail report and what insights it can provide to finance-related activities in your practice.

Unfortunately, fraud is as prevalent in dental offices as it is in the rest of the world. By taking preventive actions and perhaps even enlisting some outside eyes, your office can move closer to making sure that your money is going into the bank and not into someone else’s pocket.

By Janice Janssen, RDH, CFE

Since her introduction into the dental field as a teen, Janice Janssen, RDH, has worked as a hygienist and in other roles, including office management, insurance billing, and collections. As cofounder of Global Team Solutions (GTS), Janice enjoys consulting because it allows her to share her techniques with the doctors, hygienists, and office staff who are on the front line every day. She is a member of the Academy of Dental Management Consultants (ADMC), and is a Certified Fraud Examiner (CFE), which positions her as an expert in dental practice fraud and embezzlement. She can be reached at

Originally published in Dentrix Magazine, Spring 2017