Rules of operation.

Your office should operate under certain rules that are understood by everyone. Consider implementing the following policies:

* Accounts payable should be settled only with a check that is attached to an invoice.

* The physician signs all checks.

* The physician is the only person who opens the envelope containing canceled checks.

* The use of petty cash should be strictly regulated and recorded.

* The total amount of accounts receivable should not exceed the average charges for a 60-day period. Your goal should be to receive payment no later than 35 days from the date of service. A delay of up to 50 days is acceptable, but a 90-day delay is not.

* Postage meters are generally a good thing.

* Advertising in telephone books is very expensive, so its effectiveness should be monitored, as should all forms of marketing.

* Employees should use a time clock.

* You should periodically review your agreements with all vendors and request better pricing from the high-volume vendors. In addition, you should periodically consider outsourcing payroll, billing, and other labor-intensive tasks.

Steven F. Isenberg, MD