7.2 Office Opening, Closing, and Daily Operations
Key Takeaways
- Office opening procedures include unlocking the facility, disarming security, checking voicemail/fax, reviewing the daily schedule, and preparing patient charts
- Office closing procedures include securing the building, activating alarms, backing up electronic data, reconciling the day's finances, and verifying all patients have left
- Daily financial reconciliation involves balancing all payments collected (copays, cash, checks, cards) against the day's transaction records
- End-of-day reports should match the total of all payments collected with the records in the practice management system
- The petty cash fund is a small amount of cash kept for minor office expenses — requires a log of all transactions and regular reconciliation
- Batch processing involves grouping similar tasks (e.g., all insurance verifications, all claims) and completing them together for efficiency
Last updated: March 2026
Office Opening, Closing, and Daily Operations
Consistent daily operations ensure the medical office runs smoothly, remains secure, and maintains financial accountability.
Office Opening Procedures
| Step | Action |
|---|---|
| 1 | Arrive early — 15-30 minutes before the first appointment |
| 2 | Unlock the facility — Use proper key or access code |
| 3 | Disarm security system — Enter the security code |
| 4 | Turn on lights and equipment — Computers, copiers, printers, medical equipment |
| 5 | Check voicemail — Listen to and document overnight messages |
| 6 | Check fax machine — Retrieve and route incoming faxes |
| 7 | Check email and patient portal — Respond to urgent messages |
| 8 | Review the daily schedule — Note new patients, procedures, double-bookings, and special needs |
| 9 | Pull/prepare patient charts — Ensure all charts are ready for the day's appointments |
| 10 | Verify appointments — Confirm today's appointments and check for last-minute changes |
| 11 | Prepare the reception area — Ensure the waiting room is clean, organized, and stocked with forms |
| 12 | Check supplies — Verify that front desk supplies (forms, copier paper, receipt paper) are adequate |
| 13 | Open the cash drawer — Verify the starting balance |
| 14 | Unlock the front door — Open for patients at the designated time |
Office Closing Procedures
| Step | Action |
|---|---|
| 1 | Verify all patients have left — Check exam rooms, restrooms, and waiting areas |
| 2 | Secure patient records — Lock filing cabinets; log off all computers |
| 3 | Reconcile daily finances — Balance the cash drawer, credit card receipts, and checks against the day sheet |
| 4 | Prepare the bank deposit — Separate cash and checks for deposit |
| 5 | Process end-of-day reports — Print daily financial summary, encounter summary |
| 6 | Backup electronic data — Per office policy (may be automated) |
| 7 | Forward phones — Activate the answering service or voicemail system |
| 8 | Route remaining encounter forms — Ensure all superbills reach the billing department |
| 9 | Turn off equipment — Power down non-essential equipment |
| 10 | Check the next day's schedule — Prepare for tomorrow's appointments |
| 11 | Secure the building — Lock doors and windows |
| 12 | Activate the security system — Arm alarms |
| 13 | Leave the building — Ensure the alarm is set before departing |
Daily Financial Reconciliation
At the end of each business day, the CMAA must reconcile all financial transactions:
The Day Sheet
A day sheet (also called a daily journal) tracks all financial activity for the day:
| Component | Description |
|---|---|
| Patient charges | All charges for services rendered today |
| Payments received | All payments collected (copays, deductibles, past-due balances) |
| Adjustments | Contractual adjustments, write-offs, refunds |
| Running balance | Accounts receivable total |
Reconciliation Process
| Step | Action |
|---|---|
| 1 | Count the cash drawer and compare to the starting balance plus cash payments received |
| 2 | Total all credit/debit card receipts and compare to the POS system report |
| 3 | Total all checks received and list them for deposit |
| 4 | Compare the total payments to the day sheet in the practice management system |
| 5 | Identify and resolve any discrepancies |
| 6 | Prepare the bank deposit slip |
| 7 | File the reconciliation report |
Handling Discrepancies
| Discrepancy | Investigation |
|---|---|
| Cash over | Recount; check for an overpayment from a patient |
| Cash short | Recount; review all cash transactions; check for an unrecorded transaction |
| Card mismatch | Compare individual card receipts to the POS report; check for void or refund transactions |
| Check total mismatch | Verify all checks are accounted for; check for a missed or duplicate entry |
Petty Cash Management
A petty cash fund is a small amount of cash (typically $50-$200) kept on hand for minor office expenses:
Petty Cash Rules
| Rule | Details |
|---|---|
| Custodian | One designated person is responsible for the fund |
| Receipts required | Every expenditure must have a receipt |
| Log maintained | All transactions are recorded in a petty cash log (date, amount, purpose, receipt #) |
| Reconciliation | Periodically reconciled (cash + receipts should equal the total fund amount) |
| Replenishment | When the fund runs low, submit a replenishment request with all receipts |
| Limit per purchase | Typically $25-$50 maximum per transaction |
| Appropriate uses | Office supplies, postage, parking validation, small emergency purchases |
| Inappropriate uses | Personal purchases, large expenses, payroll, equipment |
Test Your Knowledge
During the daily financial reconciliation, the CMAA discovers the cash drawer is $20 short. What should the CMAA do FIRST?
A
B
C
D
Test Your Knowledge
Which of the following is an appropriate use of the petty cash fund?
A
B
C
D