Third Highest Occupational Fraud Rate Afflicts Health Care

Practical ways to detect and prevent revenue cycle fraud, Ms. Webster said, include segregation of duties in the accounting department; using lock box; controlled access to billing system functions; review of accounts receivable aging and past due balances; review of patient accounts with a “hold” code; review of work areas and trash for evidence of secondary record keeping; mandatory vacations (with a substitute performing functions); rotation of duties (preferably without notice); follow-up on old deposits in transit or late deposits; electronic receipt of payments; and follow-up on patient complaints about billing.

Ms. Webster also warned about using facsimile signature stamps. “The person who has access to this has check-signing authority, even if they are not an official check signer,” she said. “If you have one of these, seriously consider getting rid of it. If you have to keep it, make sure that the accounts payable clerks do not have access to it.”

Other ways to prevent and detect occupational fraud include establishing a hotline for tips, conducting criminal background checks before hiring new employees, and providing some ethics training.