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

Consistent daily operations ensure the medical office runs smoothly, remains secure, and maintains financial accountability.

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

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

At the end of each business day, the CMAA must reconcile all financial transactions:

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

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

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

A petty cash fund is a small amount of cash (typically $50-$200) kept on hand for minor office expenses:

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?

Add $20 from petty cash to balance the drawer

Recount the cash and review all cash transactions for the day

Report the shortage to law enforcement

Ignore the discrepancy since it is a small amount

Test Your Knowledge

Which of the following is an appropriate use of the petty cash fund?

Paying for a new computer for the office

Purchasing a box of copier paper from the office supply store

Reimbursing an employee for their lunch

Paying a medical supply vendor invoice

Sections you finish are checked off in the contents.

7.3 Inventory and Supply Management

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