Keeping track of income at the front desk, reconciling, and balancing at the end of the night are all important aspects of the front desk job description. The lack of standard operating procedure in this area can lead to many unfavorable outcomes, from missing money, to sloppy procedures. The following implementation guide is to be used along with the End of Day Balancing procedure as a guide for making cash transactions at the front desk easy, efficient, and accountable. If you sell nutritional supplements,
supplies, or must charge tax on products sold, it’s often inconvenient if a patient wants to pay cash. For this reason, keeping a set amount of money in a cash bank to begin the day makes sense. Note that this is not the procedure for keeping petty cash at the front desk. The guidelines for this process are outlined in another implementation guide.

In addition, it should be realized that sloppy procedures around your front desk finances can lead to missing money and can even breed embezzlement. Shoddy accounting procedures and the lack of systems can lead an unscrupulous team member to think that nobody is watching, and that is an invitation for trouble. Use of the End of Day Balancing procedure with this cash till process will foster an attitude of meticulous recordkeeping and organization.

    1. Decide how much cash is necessary to keep at the front desk to make change on a daily basis. This will depend on your clientele, how much over the counter, non-service related sales you have, and many other factors. Usually, $50 or $100 that is reconciled daily is sufficient.
    2. Place the desired amount of cash in a receptacle that is easy to manage. Some keep an independent, zippered bank bag for daily cash. Others have secured an actual cash till that can be locked up in a drawer during the day. Whatever works for you is just fine.
    3. Make sure that you start with smaller bills and some coins. Depending on your need to make change from odd amounts, such as after adding sales tax to a nutritional supplement, you may or may not need to include nickels and pennies. Whatever denominations you choose, make sure it all adds up to your starting amount of cash.
    4. Each day, whoever opens the office or front desk in the morning will add up the cash to ensure that you have the expected dollar amount. If it’s always $50, for instance, the opening CA will total the money, and certify that we are starting with the correct amount of money.
    5. In order to make this system compliant and trackable, your standard operating procedure for collecting cash payments must include the step of either writing a cash receipt from a carboned, numbered receipt book, or ensuring that a receipt can be printed from your practice management software. It is also recommended that a sign be posted next to the front desk indicating to patients that if they pay cash, they must receive a printed or written receipt.
    6. Proceed through the day’s business and collect cash and make change as appropriate. All cash paid throughout the day for services, products, and supplies should be kept in this till. Do not mix this money up with petty cash.
    7. At the end of each shift, or at the end of the day, total the cash. Compare this number to the practice management software’s day sheet for cash collections. The total of cash in your till should be the amount of your day’s cash collections, plus the amount you started with that morning. It’s recommended that you do a trial balance at the end of the first shift to make sure you’re on track. End of the day balancing procedures, including the KMCU End of Day Balancing Form we recommend, will walk you through the final process.
    8. Once the amount of cash in your till is added, balanced, and is found to equal the daily income reported in cash, remove this amount from the total, and set it aside. This will be added to your front desk deposit. You should be left with exactly the amount of your starting cash till. The closing CA should certify that this amount is correct, and then lock the money in the appropriate place for overnight safekeeping until the next morning when the process starts over again.
    9. Be sure you carefully separate the money that will go into the front desk deposit. Keep in mind that it’s best to maintain a variety of bills and change that can be easily used for change making in your cash till. If necessary, visit the bank periodically to break larger bills down to appropriate change making bills.
    10. The doctor or office manager should periodically check the opening and closing cash till to certify that it is correctly reconciled.