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Helping Health and Wellness Business Owners (Medical Spas, Private Practices, Therapists, Medical Practices, Day Spas) Fall Dangerously in Love With Finance 💰✨
https://tr.ee/hbof

06/11/2026

How does your monthly credit card review catch employee fraud if one person approves the charges and pays the bill? When the same person handles both, your review is only as honest as their records. In a health and wellness practice, credit card fraud can start with who can touch the money.

A practice manager who controls the cards and the accounts that pay them is checking their own work. A personal charge can move through your practice accounts with little more than a few keystrokes.

In forensic work, the theft hides in the volume of everyday spending. It reaches the practice cards, the operating accounts, and even the money an owner sets aside for equipment or reserves. The damage can run for years before a statement starts to look wrong.

Run it yourself: who approves the charges, and who pays the bill? If that is one name, you have a separation-of-duties problem worth a closer look. Would you have caught this in your own books? Tell me in the comments.

Send this to any practice owner who lets one person both spend on the cards and pay them down.

Follow Lozelle Mathai | Health & Wellness Accountant to keep this out of your books. Every two weeks on Forenic Friday, we break down the internal controls that protect your practice from embezzlement, unauthorized card use, vendor and payroll schemes, and administrative fraud.

06/10/2026

Fraud inside a medical practice does not stop when you hire an outside bookkeeper and an outside biller. The vendors, the front desk, anyone you stop watching can still steal from you. Pull last month's collections report and match it to your bank deposits, then explain every difference.

You can outsource the work, but you still own the risk. The biller and the bookkeeper each see one half, and neither audits the other. If one firm does both, that check disappears, and a single vendor controls the whole money picture.

A cash copay the front desk pockets never reaches the biller. The biller can create a refund for a patient who never overpaid, and it gets paid out when refunds go unreviewed. If the bookkeeper has bill-pay access, a fake vendor gets paid and the books get cleaned to match.

You make embezzlement hard to hide with internal controls. Match the day's schedule against what the front desk collected, not just the biller's report. Reconcile the biller's monthly collections against your bank deposits yourself. Review every refund and write-off over a set dollar amount. Keep payment authority in your own name, give the bookkeeper view-only access, and approve new vendors and payroll changes before they happen.

You hired outside help to stop worrying about the money. The people you never audit are the ones counting on it.

Save this and send it to your partners. Follow for more forensic insights meant to strengthen the practice you've worked hard to grow.

06/10/2026

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06/04/2026

A card payment gets recorded as paid in your practice management software but never reaches your merchant account.

Two records should agree on every card payment. Your practice management software posts it at checkout, and your processor captures the same transaction in the day's batch and settles it to your bank. Match them transaction by transaction, because timing and fees move the daily totals around.

One extra card reader is all it takes. An employee runs the patient's card on it, hands over a receipt, and clears the visit in your software. The patient is satisfied, your books look collected, and the stolen payment settles into an account that is not yours.

Reconcile every posted card payment to a matching transaction in your processor's settlement report. Timing can delay a payment, not erase it, so a posted payment with no match there went somewhere else.
Segregation of duties means the person who checks out patients and runs the card should not be the one who reconciles the merchant statement.

Follow for the internal controls that catch a card payment diverted off your merchant account.

Save this to reconcile your card payments to your processor's report this week. Send it to a practice owner who has never matched their software to their processor's report. Then comment: at your practice, who reconciles the merchant statement, and who runs the card at checkout?

06/03/2026

Run your adjustment report by employee and see whether one person is writing off balances that no EOB explains.

Write-offs are normal in a medical practice that takes insurance. The insurer pays less than you billed, so the difference routinely gets adjusted off. A fraudulent write-off looks like one more contractual adjustment in a column full of them.

This is skimming, an internal theft that an adjustment conceals. An employee pockets the patient's cash and posts a write-off to clear the balance. The account closes, the patient owes nothing, and your bank reconciliation still balances to the penny.

Every write-off should trace to an explanation of benefits from the payer, or another documented reason, and a fraudulent one will not. Review your adjustment report, and for each write-off, confirm that documentation exists. Segregation of duties means whoever collects payments should not be the one who can post a write-off without review.

Follow for the internal controls that keep your revenue cycle honest, from the front desk to the write-off.

Save this to review your adjustment report at your next leadership meeting. Send it to a practice owner who trusts the adjustment column without checking it. Then comment: at your practice, who can post a write-off, and who confirms there was an EOB to justify it?

06/02/2026

Someone on your front desk could be refunding patient money to their own card right now, and your books would still balance.

A refund looks like a routine correction. The patient overpaid, the front desk credits the money back to the card, the balance clears. So when an employee runs a refund through the practice's card terminal, it reads as one more correction.

The same person can take payments and issue refunds, so the money leaves with no second approval. Worse, a cash or manual refund does not have to return to the original card, so it can go to an account the employee controls. A fraud examiner calls that a fraudulent refund.

Refunds deserve the same scrutiny you give payments, since a refund moves money out of the practice and that direction gets watched far less. Segregation of duties means whoever can take a payment should not be the one who approves a refund. Review the refund report and confirm that each refund ties back to a credit balance on the patient's account. A refund sent to a new account, or one with no credit to support it, is where the questions start.

Follow for the internal controls that keep money from leaving a medical practice through the refund button.

Save this to review your refund approvals at your next leadership meeting. Send it to a practice owner who watches revenue and ignores refunds. Then comment: at your practice, who approves a refund before it goes out, and who checks where it went?

06/01/2026

How do you know every payment your front desk collected actually reached your bank account?

Most owners assume monthly bookkeeping would catch a problem. It won't.

A medical practice completed thousands of patient appointments before anyone noticed the cash never reached the bank. The statements looked normal and the bank reconciliation balanced. The money still went missing between patient checkout and the deposit. That is revenue leakage at the point of service.

Bookkeeping records what enters the accounting system. It does not confirm that a completed appointment produced the payment it should have. That is where skimming and unauthorized write-offs happen, and where embezzlement goes undetected.

A front-desk employee can adjust a patient balance, post an unauthorized discount, or reverse a payment in the practice management system before anyone reviews it. The appointment still shows completed and the daily revenue report still looks reasonable, but the collected cash and the actual deposit no longer match.

This is a revenue cycle control that depends on segregation of duties. The person collecting patient payments should not be the only person reviewing the deposits. That second review is the internal control most practices skip. It applies to medical practices, med spas, dental offices, chiropractic clinics, and therapy groups.

One of the first tests I run in a forensic revenue assessment is matching completed appointments to actual bank deposits. When that check never happens, the weakness of control turns into a fraud opportunity.

Compare yesterday's appointments to yesterday's deposits. Any difference deserves an explanation.

🍃Save this for your next revenue review. Send it to a practice owner who counts on monthly bookkeeping to catch this.

05/28/2026

How does an office manager embezzle $345K from a healthcare practice without the monthly financials catching it?

For nearly eight years, an office manager at a San Antonio dermatology practice ran a hidden slush fund. She altered a signature stamp, forged his signature, diverted patient payments, and intercepted IRS-bound tax checks. The monthly P&L showed nothing wrong because the stolen money never made it onto the main books. Your P&L can't show you what bypasses it.

The owner trusted his office manager. In healthcare practice ownership, trust is the same thing as reliance. When one employee controls your daily deposits with no second set of eyes, your fraud detection is only as strong as that person's honesty.

Three controls catch this fraud before it compounds:
✅ Annual audit of every account using your EIN, plus a business credit report
✅ Daily deposit reconciliation against expected patient revenue
✅ IRS verification of tax payments through EFTPS, not through your payroll provider

Save this if you own a healthcare practice and trust one employee with your daily deposits.

05/27/2026

Your monthly P&L review is not built to catch vendor payment fraud. The vendor master file is where vendor payment fraud begins, and you have probably never audited it.

A vendor master file lists each party your clinic pays: suppliers, contractors, service providers, professional fee recipients, and refund destinations. When one person can add new vendors, approve invoices, and release payments, the file becomes a single-person system. A ghost vendor can exist on the file with just that person's keystrokes.

Three patterns recur in clinic AP fraud. Ghost vendors are companies that do not exist as operating businesses but receive payments routed through legitimate-looking invoices. Pass-through schemes use legitimate vendors to overbill, with the inflated portion kicked back to the employee. Duplicate payments process the same invoice through two channels, with the second payment going to a controlled account.

A forensic vendor payment assessment examines the vendor master file for ghost vendors, addresses that match employee records, recently added vendors with no prior payment history, and bank account numbers that overlap with payroll. It tests the three-way match between purchase orders, receiving reports, and invoices. The assessment identifies round-dollar amounts, sequential invoice numbers from a single vendor, and invoices falling just under the approval threshold.

If your growing health and wellness practice has financial oversight that has not kept pace, follow . Every week we break down the internal controls that protect a growing practice from disbursement fraud, ghost vendors, and duplicate payments.

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Tulatin, OR

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Monday 8:30am - 4pm
Tuesday 8:30am - 4pm
Thursday 8:30am - 4pm
Friday 8:30am - 4pm

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+19713370444

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