Accounting Specialists
to the Medical Profession


CPAs4MDs Guide to Practice Management and Internal Control


Segregation of Duties


Internal Controls

Tracking Accounts Receivable

Eliminating Accounts Receivable

Monitoring Insurance Payments


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ding Supervision

Each staff person should complete his or her own job description manual to be reviewed by the practice administrator. In the event of employee turnover, the manual can be used by the new employee as a reference and for training by the practice administrator. Properly trained employees increase office efficiency, and ultimately, profitability. The manual should be reviewed and revised periodically, as needed. Each employee should be responsible for drafting or compiling the data for their respective position, including any forms or schedules used in the performance of that person's job function.

Supervision is the best way to keep medical practice operations moving at a desired pace and to handle unusual situations as they occur. Supervision also allows employees to obtain feedback on their job performance and discuss any job uncertainties with the practice administrator. As an employee becomes more proficient in his or her job function, less supervision time is required.

The primary responsibility for supervision rests with the practice administrator. The practice administrator should meet with each staff person, as necessary, but at least weekly to review job performance, discuss problem areas and to ensure that the employee is confident in his or her ability to perform well.

It is also advisable for the physician to periodically visit each employee's work station to provide encouragement and to demonstrate an interest. The practice administrator acts as the liaison between the support staff and the physician, reporting any unusual circumstances as well as the results of the weekly review meetings. The physician can, in turn, evaluate the performance of the practice administrator based on the frequency of these reports and their contents. Working meetings with the practice administrator should be scheduled at least weekly to assess and gauge the progress of the practice and anticipate potential problems.

A monthly lunch meeting should be scheduled with the entire office staff. This meeting shold be conducted as an open forum during which all individuals are encouraged to discuss any ideas they may have to improve their job efficiency. Many excellent recommendations have emanated and been implemented because of employees' observations and experiences.

The practice administrator and the physician should schedule meetings for the entire year in advance and be sure to block out the time in the office appointment book. A byproduct of these meetings is the opportunity for the physician to interact with his office staff in a less formal manner and humanize the employer-employee relationship.

At the weekly meeting the practice administrator or the physician should review and discuss the following:

ding The Daily Activity Report - noting total charges, payments, adjustments and net accounts receiveables.

ding The Accounts Receivables Aging Schedule - noting which accounts receivables are long past due and should be submitted for collections as well as which third party providers are lagging in payment and need to be pursued more aggressively.

ding The collection percentage, collecting period and the percentage of the front-office collections rate.


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