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Preventing Employee Fraud

Every Friday evening, Tom Girton, administrator of the Pediatric Center in Glen Allen, Va., e-mails a report of the week’s financial activity to each physician in the group.

He doesn’t ask doctors to sign checks when they are seeing patients, and he periodically provides a list of total disbursements by vendor for physicians to review.

These are only a few of the internal controls Girton implemented when he was hired to help the 12-physician medical group after his predecessor was caught embezzling. Girton’s predecessor had worked for the practice for about 20 years and was a trusted member of the team, Girton says. It was not until one of the newer physicians in the group started asking questions that the fraud was discovered.

“One of the younger doctors said, ‘I am working way too hard; I can’t believe I am not making more money than this,’ ” Girton says.

The former administrator was terminated in 2004 on suspicions of theft, according to Girton. Court records show that she was charged with mail fraud and aiding and abetting in December 2006 and that she pleaded guilty in January 2007 in U.S. District Court, Richmond, Va. She was sentenced in May 2007 to 15 months in prison and two years of supervised release and was ordered to pay $97,464 in restitution.

The physicians at the Pediatric Center aren’t alone. Approximately $994 billion is lost annually to employee fraud in the United States, according to the latest data from the Association of Certified Fraud Examiners. After financial services and government, healthcare is the industry third most likely to be affected by employee theft, according to the most recent ACFE survey.

The Medical Group Management Association recently completed a survey to collect data on embezzlement in medical practice groups. According to the survey—the full results of which will be released this summer—44% of reported thefts occurred when employees stole cash receipts either before or after they were recorded on the practice’s books. David Gans, MGMA’s vice president of innovation and research, says the median amount of reported employee theft was $5,000 and was stolen over a median period of eight months.

“Employees are seeing hundreds or thousands of dollars go past them everyday,” Gans says. “So, if you don’t have good controls in place, a $20 here and a $20 there, and before long, it adds up.”

Denise McClure, president of Boise, Idaho-based Averti Fraud Solutions, collaborated with the MGMA on the survey. She says medical practice groups are particularly susceptible to embezzlement because they typically operate with a small number of employees, which can create a familial subculture and a perception of mutual trust.

“Doctors want to practice medicine more than they want to practice business management,” McClure says. “So, they often believe the right thing to do is to hire someone and trust them.”

But that attitude, McClure says, can lead to problems. She believes in the so-called 10/10/80 rule: 10% of employees definitely will steal; 10% never will, and the remaining 80% may commit fraud if the right opportunity arises. With that in mind, McClure says, the most effective way to prevent employee theft is to properly segregate duties.

For example, the person who processes invoices should not also apply payments. And ideally, someone who has no responsibility for bank deposits or bill payment should review bank reconciliations. However, because many medical practices have one- or two-person accounting departments, separation of duties is often impossible.

“When you can’t segregate, monitoring and oversight is the next best thing,” McClure says.

That can mean implementing surprise audits, cross-training employees to do one another’s jobs, or setting up an anonymous hot line through which employees can report suspected fraud.

“It doesn’t really matter what it is, as long as employees know you are going to be looking at their work,” McClure says.

Because employees who appear to be the most trustworthy are sometimes the ones who end up stealing money, it can be difficult for employers to identify perpetrators. However, New York attorney Preston Ricardo, who has worked on several occupational fraud cases, says some common indicators include extreme personal financial problems, lavish purchases that are beyond the employee’s means, people who seem disgruntled about their salaries and workloads, and those who work odd hours or never take vacations.

Ricardo says small-business owners who are victims of employee theft frequently are reluctant to press charges for fear of attracting negative publicity or alarming investors. But, he says, victims should also consider the possibility that they may be able to recoup losses.

“There are ways in our legal system for getting a good portion of the money back,” Ricardo says. “We’ve been able to get some good settlements for our clients.”

Source: ModernPhyisican

Support Compliance Initiatives

For Healthcare organizations, Open Text Fax Server, RightFax Edition (formerly Captaris RightFax) provides the best option yet to securely send, receive, and store confidential information about patients, providers, and insurers. A centralized document delivery hub fully supports regulatory compliance. The system also provides tamper resistant document delivery and receipt as well as encrypted and certified delivery options.

HIPAA and Open Text Fax Server, RightFax Edition

HIPAA regulations require health care organizations to be more efficient and to run their organizations more securely to enhance patient service and ensure the privacy and security of private personal health information. The road to HIPAA compliance can be a challenge. Access to personal health information must be limited and its confidentiality must be diligently protected. Secure systems and processes must be in place to provide information in a timely, efficient, and cost-effective way to the people that need to use it to drive patient healthcare decisions. In addition, healthcare organizations need to provide a reliable audit trail for tracking and reporting communications.

Key HIPAA Privacy and Security Areas Authentication

• Exchange: In any exchange of electronic data, each party to the transaction must prove that every other party is exactly who they claim to be.
• Access: All medical records must be secured from unauthorized access-even amongst its own employee body.
• Reporting/tracking: Log all access, transfers, and use of patient data (including for backup purposes), and audit those accesses, transfers, and uses against patient authorization.

Sample Processes and Information Impacted by HIPAA

• Health claims and equivalent encounter information
• Enrollment in and disenrollment from a health plan
• Eligibility for a health plan
• Healthcare payment and remittance advice
• Health plan premium payments
• Referral certification and authorization
• Coordination of benefits
• Prescriptions

Source: Open Text

Secure Fax Document Delivery

Encryption and Certified Delivery of Sensitive Documents with Fax Server Documents can be sent with Fax Server using encrypted or certified delivery options that keep information private and secure.  This is critical to ensure documents are kept private and secure and helps healthcare organizations ensurance regulatory compliance.

Sending Documents via Certified Delivery

When a user sends a document via certified delivery, the document is not sent directly to the recipient. Instead, it is sent to the organization’s Fax Server certified delivery Web site called Fax Server Secure Documents. The recipient receives an email message that indicates a certified document is available, with a link to the Fax Server certified delivery Web site.

All first time visitors to the Fax Server Secure Documents Web site must create a password upon access to the site. Each subsequent time recipients visit the site they must supply the password. Certified document recipients can change their passwords at any time.

Fax Server stores the history of each certified document so users can track when the document was sent, when it was retrieved by the user (or if it was not retrieved), and when each attachment to the certified document was viewed.

Sending Encrypted Documents

When an encrypted PDF document is sent, the recipient receives an email message with the document attached as a PDF file. Users can select to password protect the document so that the recipient is required to type in the password in order to open and view the document. The recipient will be prompted for this password each time the file is opened.

Receiving Encrypted Documents

For encrypted PDF files sent via certified delivery, the recipient must log on to the Fax Server Secure Documents Web site and download the file. The recipient must enter a password for the PDF file to gain the permissions established for the file.

For encrypted PDF files sent via email, the recipient receives the PDF as an attachment to an email message. The recipient must enter a password for the PDF file to gain the permissions that you established for the PDF file.

Document Traffic Reporting

Open Text Fax Server, RightFax Edition stores detailed information about each sent and received fax. The Fax Reporter administrative utility organizes and presents this information for reporting and billing purposes.

With Fax Reporter you can

• Create fax information reports from new and existing data sets.
• Save data sets as Microsoft Access (.MDB) files.
• Export reports to other file formats including HTML, Microsoft® Office Word, Microsoft Office Excel®, TXT, RTF, and email through Microsoft MAPI or Exchange.
• Generate graphs and/or lists of fax information.
• Preview reports before printing.
• Create custom reports or use the standard report forms. In addition, Fax Server provides advanced document-based notification options using Fax Server Production Fax, FaxUtil, FaxStat, and within Microsoft Office Outlook® and IBM Lotus Notes. These comprehensive notification features allow users to monitor their document delivery status and ensure that their documents are delivered to the right destination.

Source: Open Text

The Benefits of a Fax Server

If you have a lot of faxes coming in and out of your office, you’ve likely dealt with some of these problems: paper jams, constant ringing, and an endless queue of employees at the machine.

Though faxing may seem like a technology of the 1980s, a lot of businesses still need to fax documents. Businesses that deal with contracts and signed documents are one example of frequent fax users. E-mail may be the transfer method of choice these days, yet somehow the fax has endured. So, if you’re a fax user, you might as well be a savvy one and take advantage of the conveniences of modern technology — the fax server.

This is a server that is equipped with fax software and is attached to both a fax-capable modem and a telephone line; modem software that allows you to send faxes over the Internet may also be installed.

How It Works

A fax server receives documents from users on your network, converts them to faxes, and then sends them over the telephone line or Internet. It also receives incoming faxes, stores them, and sends them along to individual users. Users on your network can send documents to the fax server in a couple of ways. They can e-mail them to the server or use a Web interface to upload the document to the server. Uploading faxes through a Web interface requires special client software, but most fax software programs are not overly expensive.

To receive incoming faxes, the fax software can send users an e-mail with their fax document attached as a PDF file. Alternatively, users can regularly check the file directory where the faxes are stored on the server, or they can use client software to log in through a Web interface and view the received documents.

Fax Server Advantages

There are several advantages to a fax server setup. The first and most obvious is that employees don’t have to leave their desks to fax; they can simply send and receive from their workstations. Secondly, fax servers can handle a good deal of fax traffic by storing and queuing up the documents that need to be sent. The server will send the faxes in the order in which it receives them.

Another key advantage: Because they are transmitted in digital form, documents don’t have to be printed before they are faxed. This saves both paper and printer ink. What’s more, incoming faxes can be printed on a standard printer, offering more readability than documents printed on a fax machine.

Faxes More Easily Stored

Fax servers also make life easier for office managers who want to make sure the company follows government data retention rules. Since all faxes are stored in an electronic file, they can be easily viewed and backed up. There is also a greater sense of transparency since managers can see which documents flow in and out of the server.

For larger companies, these management advantages can be a key selling point for fax servers. Larger companies with multiple fax machines can also cut down on telephone lines with the Fax over Internet Protocol (FoIP) technology.

The good news is that smaller companies can still reap the benefits of a fax server, even if you cannot afford to invest in a dedicated server. You can install software and a fax modem on a server that does multiple tasks.

Whether your company is large or small, it’s worth considering the advantages of a fax server. After all, the fax has come a long way since we began buying those huge, beeping machines in the eighties.

Source: AllBusiness

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