Patient Check Deposits: How to Ensure Every Check Reaches the Bank
A check arrives at the front desk. Between that moment and when it reaches the bank, countless things can go wrong. Here is how to ensure they do not.
📚 Part of our reconciliation series: This article is part of The Complete Guide to Dental Practice Reconciliation, our comprehensive resource on closing your books accurately and preventing revenue leakage.
Why Check Handling Matters
Patient checks represent real revenue that is vulnerable at every step. Unlike credit cards that deposit automatically and EFTs that arrive electronically, checks require physical handling, manual processing, and intentional action to become deposited funds.
Every touch point is an opportunity for error or loss. Checks can be misplaced, stolen, posted incorrectly, deposited to wrong accounts, or simply forgotten in a drawer. Strong check handling procedures protect revenue and prevent the reconciliation nightmares that follow when checks go astray.
The Check Lifecycle
Checks flow through distinct stages from receipt through deposit, each requiring specific controls.
At receipt, the front desk accepts the check from the patient and provides a receipt. The check should be immediately endorsed, logged if using a manual tracking system, and secured until processing. The key principle at receipt is immediate endorsement because once endorsed for deposit only to your practice, a check has limited value to anyone who might steal it.
At posting, the payment is recorded in the practice management system. The check amount must match the PMS entry exactly. The check number should be captured for reference. The patient account should be credited for the correct amount. Common posting errors include wrong amount entered, wrong patient credited, duplicate posting, and payment type confusion.
At deposit preparation, individual checks are grouped for bank deposit. All checks for the deposit must be accounted for, the deposit slip must be completed accurately with itemization, and the deposit total must match the sum of individual checks which must match the PMS total for those checks.
At deposit execution, funds are physically or electronically sent to the bank. Whether using remote deposit capture or physical branch deposit, the deposit must be made timely, a deposit receipt must be obtained, and the deposit must be secured until confirmed.
At reconciliation, the deposited amount is verified against what was recorded. Bank deposit must match deposit slip which must match PMS records for those checks. Any variance requires investigation and resolution.
Receipt Best Practices
Endorse immediately using a stamp that includes For Deposit Only, your practice name, and your bank account number. This restrictive endorsement limits what can be done with the check if lost or stolen.
Provide patient receipts that show payment date, check number, amount, and patient name. Receipts protect patients and create documentation if questions arise later.
Log checks using whatever system works for your practice whether that is a manual log book, spreadsheet, or PMS entry. The key is creating a record at the moment of receipt so that checks can be tracked through subsequent steps.
Secure checks immediately by placing them in a designated location rather than leaving them scattered across desks. Use a lockbox, drawer, or secure area accessible only to appropriate staff.
Posting Best Practices
Post same-day to minimize the gap between receipt and recording. Checks that wait to be posted create reconciliation challenges and increase loss risk.
Verify amount carefully by double-checking the check amount against what is entered in the PMS. Transposition errors are common and create balancing problems later.
Capture check number in the PMS payment record. This detail is essential for reconciliation and research when questions arise.
Review before finalizing by confirming the correct patient, correct amount, and correct payment type before saving the transaction.
Deposit Preparation Best Practices
Prepare deposits daily because daily deposits minimize risk and simplify reconciliation. Checks waiting to be deposited can be lost, stolen, or forgotten.
Complete deposit slip accurately by listing each check individually if practical, totaling correctly, and including your account information.
Verify totals match by confirming the deposit slip total matches the sum of checks being deposited which matches the PMS total for those specific checks. If totals do not match, investigate before proceeding.
Document the deposit by making a copy of the deposit slip and checks, or capturing images through remote deposit. This documentation supports reconciliation and research.
Remote Deposit Capture
Many practices now use remote deposit capture which allows check deposits via scanner or mobile device without visiting the bank. RDC speeds deposits, eliminates transit risk, and creates automatic images.
Best practices for RDC include scanning same-day, verifying image quality before submission, retaining physical checks per your bank's requirements, and reconciling RDC deposits just like physical deposits.
Even with RDC, checks must be handled properly before scanning. All the receipt and posting best practices still apply.
Physical Deposit Best Practices
If making physical bank deposits, minimize transit risk by depositing daily or multiple times weekly rather than accumulating checks. Use secure transit by avoiding visible bank bags and varying routes and times if concerned about theft risk. Obtain and retain deposit receipts as proof of deposit.
Reconciliation
Daily reconciliation should verify each day's check deposits match PMS records for checks posted that day. Compare deposit receipt to deposit slip to PMS payment records. Investigate any variance immediately while details are fresh.
Monthly reconciliation should verify the month's total check deposits match total check payments posted in the PMS. This catches any items missed in daily reconciliation.
Common reconciliation issues include checks posted but not deposited, checks deposited but not posted, amount mismatches between PMS and deposit, and timing differences at month-end.
When Things Go Wrong
Missing checks require immediate action. Check the last known location, check with anyone who handled the check, review security camera footage if available, determine if the check was posted in the PMS, and contact the patient to request a replacement if necessary.
Returned checks require following your returned check procedure, reversing the PMS posting, contacting the patient for replacement payment, and documenting the entire situation.
Posting errors require identifying the error through reconciliation, correcting the PMS entry, documenting the correction, and understanding how the error occurred to prevent recurrence.
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