When given the task to manage an Optometric Practice, you have a few decisions to make. Am I going to manage a problem as it arises or am I going to manage in such a way that I prevent it before it happens?
If you have experienced staff, doing just about nothing regarding management, the practice will survive surprisingly well for some time. Then you wake up one day, and everything is in a mess. There are no files to refer to; there are no staff records; stock takes have never taken place and you have to write off 30% of bad debt. You may then ask yourself: how did you not notice the decline in your monthly turnover? How come your cash flow is in such a mess?
The day-to-day management of a business requires dedication and insight. By checking a few of the Critical Factors of your business daily, very little can surprise you! Knowing exactly what to monitor is critical. You do not have to be an accountant or the former CEO of a listed company either. You only need to pay attention to what happens in your practice every day.
I am not implying that you do not need an accountant or an auditor. Of course, you need one! Just keep in mind that they can only do their jobs well if you supply them with the correct information. Inaccurate information will lead to inaccurate reports. If your day-to-day management of the practice is up to date, your monthly reports will be up to date too. In turn, your accountant will be able to give you your management reports on time (at the very latest – 15 days after month-end) which means that you will never need to manage your business on a postmortem basis.
Your practice’s management software generates a daily report. Because this report is merely a summary of everything that was generated on the computer system for the day, your first priority must be to ensure the accuracy thereof!
What do we need to check?
- Have ALL patients been invoiced today?
- Have all receipts been posted on the system – medical aid payments as well as EFT’s?
- Discounts
- Are all credit notes, refunds and journals posted correctly and authorised by the practice manager?
- Did the cash balance?
- Check stock movement for the day
- Were all patients/customers invoiced?
Use the practice diary as a management tool for this function. Ensure that employees write the invoice number next to the patient’s name after completing the invoice. If only a quote was generated, record the quote number in pencil. Once the quote is converted into an invoice, replace it with the invoice number.
There are various types of electronic diaries. If you use one of these systems, find a way to record the invoice number. An option can be to print the diary together with the day-end report and record the invoice numbers on the printed version.
- Discounts
Are your employees authorised to give discounts to patients? If yes, check discounts allowed to ensure that there are no irregularities here. Instruct employees to record the amount of discount given, the reason for giving it and the person authorising it on the patient profile. Your duty as the manager will be to check that those notes have been made once you see that a discount was passed.
- Have all receipts been posted on the system?
Some practices have a very dangerous dual system for receipts. When the patient pays, a hand-written receipt is generated. This receipt is later posted on the computer system.
Why “dangerous”? I am often asked to check irregularities in practices. Ninety percent of cash theft in practices is due to the fact that there is more than one system for receipting. It is therefore very easy to introduce a third hidden system. I can elaborate at length on how it’s done but this is not the place. Please email or contact me and I will explain. (www.daleenslabbert.co.za)
Your software has a very easy-to-use function for receipts, use it!
Ensure to check your bank statements regularly (at least every second day) for medical aid payments and Px EFT’s. Ensure that, once given to the relevant employee, the receipting is done on the same day.
Please do not let your staff have to nag you for the statements.
- Are all credit notes, refunds and journals up to date?
No employee should have unsupervised access to these functions – even if they have been working for you for 20 years! It takes a few minutes now and then to manage this function. Should you need to do a full invoice credit, journal or refund let the employee print the relevant invoice and write the detailed reason on the invoice. This is given to you for processing. Remember – set the example for your employees and do not procrastinate!
Keep proper record of these transactions.
- Did the cash balance?
Have you got a banking system in place that will show if there is even the smallest discrepancy?
In most of the bigger cities, cash is no longer the preferred mode of payment. Patients pay by credit/debit cards and EFT’s. Cash is mainly used for smaller payments such as contact lens solutions and eye drops. Even so – your sales must be balanced with your daily report every day! In busy times, a front liner may have delayed the receipting of a patient’s credit card payment and then forget to do it. This will soon lead to an agitated patient.
Design an easy to use banking system on excel or download one from http://www.daleenslabbert.co.za/business-toolbox-by-daleen-slabbert-consulting/.
If your banking does not balance, compare the total cash received to the cash receipt summary on the daily report. Next, check the totals for cheques and credit cards. This will point out where to start looking for your error – in the cash, cheques or credit card totals.
Check all medical aid remittances to ensure that the correct amounts were posted and that the batch is balanced. Medical aid discounts are often the culprit for incorrect totals.
Ensure that patient files are not filed away before the daily banking balances!
If you cannot find the error, do not force-balance it. “Over” or “under-bank” the amount with clear notes. In a day or two, the error may show itself and can be identified on the daily banking sheet summary.
Write up your banking in the bank deposit book and bank it. If you feel that there is not enough cash to make a trip to the bank worthwhile, keep it in the safe and bank it together with that of the following day. There would not be a bank deposit slip if there was no cash to be banked.
Record your day-end figures in the day-end summary if you have one. File all the related documentation daily.
- Check stock movement for the day
There are a few ways to keep an eye on stock movement. This section is not dedicated to the general management of stock but merely on how to keep track daily.
The last page of your daily report (if set up that way), lists all the stock items sold on that specific day. If your stock is securely locked away, you can fill these spots after checking the sales of the previous day. Keep in mind that there may be frames in job trays that have only been quoted on and that a full invoice credit returns a frame into stock. In short – if there were 10 frames sold, there should be 10 empty spaces. I do not like this system (even though it works!) because I do not like empty spots. Rather, get to know your stock and keep your eyes open.
Do sweeping stock takes and regular full stock takes to ensure that there is no pilferage.
MANAGEMENT CHECKLIST
DAILY TASKS TO BE MONITORED
| Task | Mon | Tues | Wed | Thu | Fri |
| Morning reports checked and signed off | |||||
| Ensure that all patients were invoiced | |||||
| Check stock adjustments (if relevant) | |||||
| Daily Banking process checked and signed off | |||||
| Checked and signed staff attendance register. | |||||
| Spot-checks done to see if px’s are notified of next day’s appointment? | |||||
| Ensure that there are no empty spots in the display units and merchandising areas. |
WEEKLY TASKS TO BE MONITORED
| Task | Wk1 | Wk2 | Wk3 | Wk4 | Wk5 |
| Petty Cash Checked & Balanced | |||||
| Weekly debtors meeting * | |||||
| A minuted staff meeting held | |||||
| Follow up on meeting action list | |||||
| Spot-checks done on jobs outstanding and why? | |||||
| Check purchase order book |
*Debtors meeting:
Have an updated age analysis present; discuss outstanding medical aid claims; discuss possible write-offs, set targets / discuss actions for the following week.
MONTHLY TASKS TO BE MONITORED
| Task | Date completed |
| Ensure that stock-taking was done | |
| Order stock according to need | |
| Check expiry dates on all solutions & drops | |
| Check that all credit returns are dealt with | |
| Ensure that all receipts (m/a and private) were posted prior to starting the month-end procedure | |
| Done month-end and Back-up (last day off the month) | |
| Double-check that the month-end back was done successfully | |
| Customer service spot-check calls to patients |