How Do You Hold Employees Accountable for Their Positions?

Surveys show that workers are happiest when they are productive and are contributing to the success of the group in which they work. To boost morale, efficiency and longevity of workers, one must:

  1. understand the importance of one’s production,
  2. know exactly what one is supposed to produce and have a clearly defined final product,
  3. be properly trained to get that product, and
  4. be specific. Generalized statements leave too much room for interpretations and argument.

Whether you have a staff of 2 or 30, each position in the practice needs to have a clearly defined final product. Both the manager and the employee need to know exactly what the person on the post is expected to produce. For instance, a receptionist’s product is “communications handled swiftly, accurately and in a friendly manner.” A receptionist who consistently obtains this final product will keep the flow lines and the communication lines of the practice functioning and will be a valuable group member. How many new patients have been lost because a receptionist has failed to answer a phone call swiftly, answer questions correctly and/or set an appointment?

Determining the final product for each position is a starting point. A statistic needs to be developed, so the final product can be monitored accurately. For example, one of an office manager’s final products is “staff members who are fully trained for their positions.” Using a statistic such as “percentage of employees fully trained for their jobs” would show the OM’s performance.

How do you hold employees accountable? The answer is:

  1. name a final product for each position,
  2. figure out a way to quantify that product as a statistic,
  3. monitor the statistic,
  4. evaluate statistical trends, and

apply the correct formula to remedy any downward statistic or improve an upward statistic.

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Generating New Patients by Using Surveys

How do you market for new patients in a cost efficient and effective manner? Starting with internal marketing is always the best approach­, as it produces the most cost effective return, which is of utmost importance in managing a practice. Surveys are one method of internal marketing. But how do you go about generating new patients by using surveys?

Here’s the first tip that you can use to more effectively market: do a simple survey with all new patients who come in, in order to find out what brought them to your practice. This can be done as part of their new-patient intake forms, or the receptionist or any other designated staff member can ask the questions verbally.

We have a variety of prepared surveys for our clients to use. Here are examples of some questions you can use to create your own survey:

  • If you were referred, who referred you and what did that person say to interest you in our office?
  • If you responded to an ad, which one did you see? What about it attracted you?
  • If you responded to our website, how did you locate it and what about it interested you?

A second tip is to use surveys on your existing patient base. Start by going through your existing patient records and find about 50 of your “A-list” patients/clients. Do a demographic search of where your best patients/clients are from. Then write a survey for those patients/clients to find out:

  • what attracted them to your practice,
  • what keeps them coming back to your practice,
  • what they like the most about your practice and
  • which services, if any, they would like to receive from you that you don’t currently offer.

You can then use this information to target the greatest demographic area of your A-list patients/clients and use their survey answers as “hot buttons” in a marketing campaign targeted to generate more patients/clients who are similar to those A-list patients/clients.

This is called targeted marketing. It’s all about generating quality patients and clients, not just getting people to walk through the door. Quality patients keep their appointments, follow your treatment programs, pay their bills, spend more than their insurance allotment, etc. These are the kinds of patients/clients you want to generate for your practice.

If you can determine in which area your best patients/clients reside and what brought them to you in the first place, you can then design a marketing campaign to generate more of those types of patients and clients.

Don’t just guess at what you think will bring new patients/clients in the door. Find out what got your best patients/clients there and use that information to your advantage. “Know before you go” is the motto of all good marketing. You find out the “know” by surveying.

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12 Steps to Collect Past Due Accounts

Collecting on past due accounts is a function that the Accounts Manager will find herself/himself having to do. Any contact with a patient/client, even under these circumstances, should be kept on a friendly, professional and dignified basis. This will promote respect for the office and its business practices.

Always remember the following points with regard to your patients/clients:

  • Most people have good intentions and want to cooperate with agreements that they have made.
  • Although a person’s account may be overdue, most people still have a good intention to take care of it.
  • Most people prioritize their bills and will first pay those that they feel are most pressing.
  • Most people with past due accounts will pay those bills where someone is actively requesting them to pay.

Bearing in mind the above, your role is to arrange to be one of the creditors that your patients/clients will not delay paying. The following points may be helpful in this regard:

  1. Bill promptly every month.
  2. Ensure that your bills are accurate.
  3. Ensure that you have the original signed financial agreement from your patient/client.
  4. Contact the patient/client as soon as you realize the account has become delinquent.
  5. When you speak with the patient/client, let them know that you believe that they are able to make payment.
  6. Let the patient/client know that you expect to be paid, and refresh their memory on the signed agreement.
  7. Allow the patient/client their self-respect; never back them into a corner, insult or badger the patient/client.
  8. Explain to the patient/client that you want to help him/her work it out so that they can maintain the agreement that they made with your office.
  9. Be prepared to offer some options to the patient/client that they may not have considered.
  10. Be willing to really communicate with the patient/client so that a true understanding and agreement can be reached.
  11. If absolutely necessary, utilize the credit reporting associations. Let the patient/client know that you are planning to do so and that this will go on their credit rating.
  12. As a last resort, utilize the services of a collection agency, and let the patient/client know that you plan to do so.

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Turn a 40 Hour Week Into 30 and Stay Profitable

Do you ever get to the end of the day and realize that you didn’t get half of the things done that you intended to get done?

Do you find yourself giving endless streams of orders and then having to spend time following up to make sure everything was really done?

Do you often have to redo work because it was not done correctly the first time by someone else?
Is scheduling a problem?

Managing time in a healthcare practice is an art. Unique problems arise because, as the doctor, your main priority is treating patients. But, how are you supposed to keep your full attention on patients and at the same time stay on top of the crucial administrative work that is paramount to maintaining a thriving practice? The essence of successful time management is the attainment of a level of organization which facilitates the goal of a healthcare practice, a high quantity of well and happy patients.

Simply stated, how well you organize determines how many hours you work and how productive you are during those hours.

If you are having difficulty managing your time, the first action you should take is to keep a time log during a typical work week. While this may be arduous at first glance, you will find it well worth the time and energy you put into it. Carry a small notebook with you throughout the day and log everything you do along with the amount of time you spent doing each. This is best done by logging the events as they happen and avoid trying to reconstruct the information at a later point in time.

At the end of the week, you will be able to look over the information and tabulate how much time was spent on the various activities you engaged in. This exact record will help you isolate areas of the practice that are not being competently handled by your employees and/or are problematic to the point of requiring much of your attention.

The next action you should take is to have each one of your employees keep their own time log, just as you did yours. At the end of the week, you can gather the logs and review the activity of each staff member.

Read part II of this article and find out the key questions you should be asking yourself when you have completed your log. Request “Turn A 40 Hour Week Into 30 and Stay Profitable – Part II” (highly recommended). Scroll to top

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How to Set Reminders for Continual Services (Recall)

Whether you are using an automatic reminder system, or it is someone’s job function to send out reminders; or a combination of both. The below information will be highly beneficial to increase your appointments scheduled, reactivating clients/patients and having them show up to their appointments.

In many offices recall can be one of the most overlooked aspects of a practice. Many offices are only utilizing about 30% of their recall poten­tial. This means that patients are not getting the care that they should, and a lot of business is slipping through the cracks of the practice.

One of the biggest problems encountered when you are trying to put in, or straighten out, a non-existent or inefficient recall system is that you may already have “trained” the patient or client that it’s not really all that important to come in for regular exams or other repeatable services. So, the first thing you have to do is let your patients/clients know how important these appointments are.

Patient/client education plays an important part in any successful recall system, whether you simply tell patients/clients or use pictures and other visual aids. The point is that you have to spend the time with your patients/clients. You might think that this is too much trou­ble to go through. But, just realize that the success of your recall system is related to the education of your pa­tients/clients and the use of the system itself.

You will always have people that will not “have the time” or “think it’s unnecessary” and will not participate in your recall program. But, most people, once they have been properly educat­ed and are programmed into the system to keep these appointments, will cooperate.

The System:

The following can be used for any type of follow-up or recall appointment:

  1. Have a supply of postcards made that the patient/client will fill out prior to leaving the office. You should also have appointment cards with spaces for appointment dates and times to be filled in.
  2. Before the person leaves the office, the receptionist should schedule them for their next appointment. They should always be scheduled for their next appointment, no matter how far away it is. (The prior education of the patient on the importance of regular exams is very important to this step going smoothly.)
  3. Put the person’s name in the appointment book and give them an appointment card with the date and time on it.
  4. Give the person a postcard and have them fill in their name and address on the card. Let them know that you’ll send the postcard out ahead of time to remind them of the appointment and that you’ll also give them a call. Having them par­ticipate in the making and scheduling of the appointment is highly effective, it creates a more solid agreement to keep the appointment.
  5. File the postcard in a file box that is divided into each week of the year. File the card in the weekly slot that is two weeks prior to the appointment.
  6. At the beginning of each week, pull out the cards for the appointments scheduled two weeks away and mail them.
  7. Using the recall confirmation dialogue, call the patients two to five days before their appointment to confirm the appointment.

You’ll find that because they filled out the card and received it in the mail, you’ll have a much easier time of confirming and keeping these appointments.

Other Tips on This System:

  1. To really get the person to comply, it is important to stress the importance of “continuing care” rather than the traditional “come and see us in 6 or 12 months” attitude.
  2. Watch the language you use too. Sometimes the word “recall” can have negative connotations. Patients may think of “defective” merchandise being recalled by manufacturers. Use “reexamination,” “reevaluation,” “regular visits,” or “regular appointments.”
  3. It is helpful to note the name of the person that the patient/client should call to make an appointment with (if appropriate) or indicate to the patient who will be calling them and when. This makes their appointment scheduling more personal.
  4. Reminder calls should be made when you are most likely to reach the person. Call after 5:00 p.m. on weekdays or on Saturday morning. Be very diligent about follow-up calls if you can’t reach the person. Make every attempt to reach the person by phone, and send letters if the phone calls are unsuccessful.
  5. Do not let patients fall between the cracks. Every patient should be in two places: in the appointment book with an ap­pointment and in the reminder system to be reminded at some time in the future of their appointment.

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The Underrated Business Card

Business cards don’t seem to be in vogue as of recently, however they are still a highly effective tool for getting your name out there. Everyone in the practice should be attentive to any and all opportunities to promote the practice. One of the easiest methods for doing so is handing out business cards. This is a successful tool and is also a commonly accepted practice in the business world.

Initially, each staff member could be given some of the doctor’s cards to distribute. Advise the staff to keep an ample supply of cards in their purse or wallet. Opportunities to hand them out will present themselves in a number of various situations. For example, when a person asks, “What line of work are you in?” The staff member (and doctor) could answer the question, say a little about the practice, and offer a business card or two.

One can take advantage of every day situations to hand them out, e.g., while at the grocery check-out counter and engaged in social conversation with the clerk, at the beauty salon, at the gas stations, the bank, etc. The list could go on and on. The idea is to keep a flow going all of the time. Many practices have been built and expanded in just this fashion.

As your budget allows, print business cards for each of the staff with their names and positions on them. This instills in each staff member a feeling of importance and professionalism. They will also experience a heightened sense of pride when handing out one of their own cards.

A staff meeting should be held during which the significance of new patients/clients is discussed. Impress upon the staff that as each person takes more initiative for building the practice, everyone will experience the increased benefits. Establish “games” for the staff wherein the staff who distributes the most cards and brings in the most new patients/clients is rewarded with cash or some other valuable prize.

The most successful method of using cards to attract new patients/clients to the practice (and to determine whose card they came in on) is to have an offer printed on the back of the business cards which extends to the recipient either a complimentary initial visit or a substantial discount on the first visit. The prospect should be informed to bring the card in with them to the first appointment. The receptionist could then record the name of the staff member as the referring source.

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Reactivating Patients: How to Get Them Back

If you were to calculate the value of each patient or client visit and multiply that by the number of patients or clients you have not seen for 6 months or more, you would begin to get the idea that you are losing significant amounts of income by allowing these patients to slip through the cracks. The reactivation of patients or clients who have discontinued care can be a major source of increased activity and income. Although they aren’t new patients or clients per se, the reactivation of these persons can produce a significant increase in activity for you. By simply concentrating on reactivating those persons who have visited you in the past, you can increase office visits and income notably.

People drop out of treatment for many reasons. It is possible that a person decided to discontinue care due to financial difficulties. By contacting them, you might find that their situation has improved, and they may be quite willing to re-establish their visits with you. It is also possible that a patient/client may have stopped coming for services because they didn’t have a full understanding of the importance of regular visits. This is a matter that could be cleared up through communication and education. Lastly, don’t rule out the idea that your former patient/client may be upset with your office, which again could simply be handled with communication. The important thing to be aware of is that communication, a caring attitude, and good follow-up can encourage people to come back to the practice.

Set aside some time to go through your inactive files and find those patients/clients whom you have not seen for at least six months. Look through the chart to determine what services they might be in need of. Compose a letter which addresses the specific service indicated.

Keep a log of letters sent out and, through the use of a reminder file, target a follow-up phone call to the client/patient within one week of sending out the letter.

When placing a phone call, make sure that you are specifically familiar with whom you are calling. Have it clearly in mind exactly what it is you are calling for. Keep a record of your phone calls which would include:

  • the date and time of the call,
  • whom you spoke with,
  • the reason for the call, and
  • the results of the call.

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Presenting Treatment Plans – The Do’s and Don’ts

Are you advocating for the patient’s health or his wallet?

How should a treatment plan be presented?

What can a doctor and staff do to ensure a high acceptance rate?

What does all this have to do with sales?

These questions, left unanswered, could potentially cost a practice untold sums, quality of care can suffer, new and repeat business can drop off, office morale can be low and practicing can lose it’s entire purpose if patients are not receiving the care that they need.

Confusion About “Sales” Will Cost Practices a Fortune.

A sale is simply an exchange where all parties involved receive something of value. In healthcare professions, a patient receives care to fix a health problem and/or maintain good health. In exchange for the work done, the staff and doctor are paid.

A successful practice includes doctors and staff who care enough to sell patients exactly what they need. Each doctor is key in the sales cycle because without the doctor diagnosing and planning treatment for the correct care, there would be nothing to sell.

Most confusions stem from the false ideas that people have about sales. High-pressure techniques used by some people can leave a bad impression and make patients/clients want to shy away from buying at all. These techniques are not true sales techniques. In fact, using them can set a doctor up for failure. So to does going out of your way to avoid using any sales techniques at all.

Convincing vs. Selling

Convincing a person that they need to buy something is a different activity than selling them on an idea, service or product. Selling is really nothing more than obtaining agreement. A patient who understands the treatment needed and agrees that it needs to be done — and they are going to do it — is a result of a successful treatment plan presentation. In an attempt to convince a patient to accept a plan, a doctor often talks too much, which in most cases works against him. Good communication, then, becomes a key factor. A doctor using communication skills that serve to enlighten and educate will bring a patient to a point of understanding and agreement.

The Patient vs. The Wallet

Doctors can become so worried about whether or not the patient is going to consider a plan too expensive that they actually neglect giving the patient the true treatment plan. We have not met a doctor who does not consider him/herself a good technician. Yet, when it comes to passing treatment information along to a patient, a doctor can get in a habit of making the presentation more palatable by reducing the plan. Concerns about what the patient might think can get in the way. The wallet, then, becomes the center of attention rather than the exact treatment that the patient needs. Doctors do know what patients need, and this should be clearly expressed to the patient or the likelihood of primarily doing “patch-up” work will enter into the practice.

Plan A or Plan B or Plan C?

The doctor may give the patient too many choices. The patient is not a physician and, therefore, does not know what’s best for him. Patients rely on the doctor to tell them what they need. If the doctor doesn’t do that but gives them a choice between Plan A, Plan B or Plan C, the patient will naturally ask the cost of the different plans and select the least expensive one. Asking a patient to make a choice between a $600 plan, a $350 plan and a $195 plan will cause suspicion. One of the most common misconceptions about doctors is that they’re all rich. A patient may wonder why you would do a $600 plan if a $195 plan will suffice.

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Workable Collection Examples and Tips

Workable Collection Examples and Tips

This article is a continuation of The Truth About Collections. If you haven’t done so yet, we recommend reading the first article to get the full picture.

Let me explain. If at the end of your fiscal year you have enough money to pay for everything, i.e., all of your overhead is covered, such as your staff salaries, your mortgage/lease, equipment payments, taxes, etc., any lost income then becomes your own lost personal net income. For example, if you were collecting an average of 93% (5% lower than what should be your standard) with an annual gross income of $650,000.00 ($55k per month), this would equate to a loss of $32,500.00 per year. Over ten years this amounts to a staggering $325,000.00! And that is essentially straight out of your own pocket. This is the equivalent of you working one year or more out of every ten years for free. Many doctors we survey think that “a few percent here or there isn’t that significant.” I hope the above numbers disabuse you of that idea.

With the above in mind, is it now worth it for you to spend the time to train your receptionist and/or collection/finance person on collecting properly?

Here are some tips on things that you can do to increase your collection percentages.

First Contact

When a new patient/client initially calls to make an appointment, the receptionist should keep it as simple as possible for the patient to arrive. So, you want to schedule them in as soon as possible. You want their first impression to be that they feel well serviced. The new patient/client should be informed to arrive early enough to fill out paperwork, so the appointment can happen on time. Payment terms and conditions should not be discussed on the phone with them. You want to make it as easy as possible for the new patient/client to come into the office and not be put off by anything during the initial contact. When they get into the office, you can then go over your financial policies. You should ask them to bring any insurance information that they have should insurance be relevant to the potential treatment. This should include the name of the company, their policy number, what is covered, what their deductible is, etc. Do not worry about having to get into the details of this over the phone and don’t make the patient feel harassed by this. You don’t want to turn the patient off before they even arrive, or they may not arrive. You want the patient to feel friendly and comfortable about coming into the office, but at the same time, you want them to bring any relevant data that they can.

When They Arrive

As soon as the new patient/client comes through the door, they need to be greeted warmly by the receptionist. The receptionist should then supply the new arrival with the necessary forms to fill out. Included should be a form covering your specific payment requirements indicating that payment is due at the time of treatment and/or your insurance agreements and arrangements. If insurance is involved, the form should include a place to provide what insurance they have, how much is covered, what the deductible is and, most importantly, that they will be expected to pay the copay, deductible or anything not covered by insurance at the time of treatment. They should also be told that, unless otherwise agreed upon, you don’t offer billing but will gladly accept cash and most major credit cards. Let them know if you offer financing through companies such as Care Credit, and if they feel that they will require such financial assistance, make sure they meet right away with the person in your office who handles these matters. If you don’t take care of it on the spot, you are likely to be left with a collection problem on this account. Make sure that you require their signature on this form that signifies that they have read, understood and will comply with the financial policy of your office

Once They Have Received Treatment

Validate your patient/client for the good decision that they made to confront and handle the problem that they came to you with. Let them know that they did the right thing and that the investment they made was a good one. Follow up the first treatment with a quality control call, ideally from the doctor, to make sure all went well.

As treatment continues, make sure that everyone in the office continues to reinforce the good decision the patient/client made, and make the patient/client feel welcome in the office.

If you do these things, you will see a turnaround in your collection percentages, and you will see your net income go up.

Questions? Ask the Editor

If you have any questions or suggestions about this article, please feel free to submit them below. Our editors speak with professional Dr’s like yourself every day. They would be delighted to hear from you.

Real Office Policy Examples and Checklist

Below is a list of items that should be included in any basic office policy or policies:

  • Patient Relations
  • Sexual Harassment
  • Orientation and Training
  • Work Hours
  • Fringe Benefits
  • Solicitation
  • Equal Opportunity Statement
  • Terms of At-Will Employment
  • Definitions of Full Time and Part Time
  • Pay Periods
  • Vacations
  • Sick Leave
  • Maternity Leave
  • Tardiness
  • Personal Time Off
  • Absenteeism
  • Staff Meetings
  • Breaks and Lunchtime
  • Unemployment Insurance
  • Problem Resolution
  • Wage and Salary Guidelines
  • Retirement Plans (if any)
  • Holidays
  • Funeral Leave
  • Leave of Absence
  • Jury Duty
  • Disciplinary Measures
  • Continuing Education
  • Workers’ Compensation Insurance
  • Health and Safety Rules
  • Appearance
  • Office Security
  • Telephone Use
  • Where to Park
  • Voting
  • Job Performance Reviews
  • Uniforms
  • Dating of Patients
  • Confidentiality of Records and Information
  • Cleanliness and Maintenance
  • Reimbursement of Expenses
  • Outside Employment


Policy is very important to establish so that the entire group understands the rules and agreements upon which the office operates. When you have good policies known and understood by all staff, you get an effective and efficient team that coordinates and cooperates at a high level.

Below are some sample policies about the subjects suggested previously. Always consult with a good employment attorney before implementing your policies to make sure that they conform with the laws of your area.

Example General Policy Introduction

Welcome to our practice. The following policies are designed to provide working guidelines for all of us. Written office policies help to:

prevent misunderstanding and lack of communication;
eliminate hasty, unrefined decisions in personnel matters;
ensure uniformity and fairness throughout the practice; and
establish the basic agreements that everyone in the office operates on.

Our practice is open to change. Changes happen as a result of internal growth, legal requirements, competitive forces or general economic conditions that affect our profession. To meet these challenges the practice reserves the right, with or without notice, to change, amend or delete any of the policies, terms, conditions and language presented in this manual. Changes in personnel policies are made after considering the mutual advantages and responsibilities of both the owner and staff. All of us need to stay aware of current policy and, as revisions are made, new pages will be given to the personnel to place in staff manuals.

Remember, your suggestions are welcome. Just notify the office manager whenever problems are encountered and wherever you think improvements can be made.

Example Harassment Policy

This practice is committed to providing a work environment free of discrimination. This policy prohibits harassment in any form, including verbal, physical, religious and sexual harassment. Any employee who believes he or she has been harassed by a co-worker, manager or agent of the practice is to immediately report any such incident to the office manager or next highest authority. We will investigate and take appropriate action.

[As harassment is a big legal issue in today’s world, we also suggest to all practice owners that a more extensive policy be written that further defines the types of harassment and the exact steps to follow should it occur. We also suggest that you check with your attorney on proper policy in this area.]

Below is a sample policy on employee classification. These classifications are important for any employer to know because they affect the type of working hours, pay, benefits and bonuses that various employees are eligible for. Some of these classifications and their accompanying benefits or restrictions can vary from state to state. Therefore, it is important that you consult with an attorney who is familiar with the employment laws in your state before implementing this type of information.

Example Employee Classification Policy

  • New Employees: this category would include those employed for less than a specified number of days, during which they are on probation.
  • Regular Full-Time Employees: this could include staff who work a minimum of 32 hours a week.
  • Regular Part-Time Employees: this would include staff who work less than the minimum required.
  • Temporary Full-Time Employees: this would cover staff who work full time but are hired for a limited specific duration.
  • Temporary Part-Time Employees: this would include staff who are hired for a limited duration and work part-time.
  • Exempt Employees: this covers staff who qualify under the Fair labor Standards Act as being exempt from overtime because they qualify as executive or professional employees. Make sure you know the exact rules and regulations on this before you exempt anyone from overtime.
  • Non-Exempt Employees: such employees are required to be paid at least minimum wage and overtime.

Example Overtime Pay Policy

Overtime pay is paid according to the Federal Fair Labor Standards Act and our state’s wage, hours and labor laws.

Exempt Employees: employees exempt from the minimum wage, overtime and time card overtime provision of the Fair Labor Standards Act do not receive overtime pay.

Non-Exempt Employees: employees not exempt from minimum wage, overtime and time card provisions of the Fair Labor Standards Act do receive overtime pay.

Overtime hours must be authorized by the office manager or owner in advance of extra hours worked or as soon as possible thereafter. Time not worked but paid for, such as vacation, holidays and sick leave will not rate or count for overtime calculation purposes.

Example Time Tracking Policy

Each staff member is individually responsible for recording work time on the attendance sheet and/or time card when reporting for work, leaving for lunch, returning from lunch and leaving at the end of the day.

The attendance sheet and/or time card is a legal document and must not be destroyed, defaced or removed from the premises. Never allow another employee to enter your time for you and vice versa.

Overtime must be authorized in advance of extra time worked or as soon as possible thereafter. Overtime, changes or omissions on the attendance card must be authorized by the office manager and initialed.

When you leave the premises, let us know. If you have to go out of the office or the building on personal business during your scheduled work hours, first, get permission from your supervisor. Then, check in and out on your attendance sheet or time card.

Whether you use the above examples or not, having written office policy is vital to the smooth operation of any practice. It is the foundation of education, training and correction in your office and can make the difference between a well oiled machine and a machine that is constantly having problems and is in need of repairs.


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