This article is co-authored by Amber Weber Gonzales and Scott Clifford, Certified Fraud Examiner.    

Dental practices across the country are moving to cloud‑based and modern software platforms, drawn by promises of greater efficiency, accessibility, and clinical support.

For the clinical team, this shift is exciting—new tools, visual treatment planning, faster access to records, and smoother workflows. But for the business side of the practice, a software conversion can quietly disrupt one of the most critical elements of long‑term success: financial integrity.

The Hidden Financial Risks of Software Transitions

When practices convert to a new system, the immediate focus is usually on restoring clinical operations and patient scheduling. But here’s the reality: the financial heartbeat of the practice is often overlooked. Without intentional setup and ongoing monitoring, you risk losing visibility into patient balances, transaction accuracy, and revenue cycle consistency. In the worst cases, you may even create an environment where embezzlement can occur undetected.

How Financial Oversight Gets Lost

Most practice owners underestimate how deeply software changes affect billing, reporting, and internal controls. Legacy data is often migrated without reconciling incomplete claims, patient credits, or account adjustments. Sometimes balances simply carry over—unverified—leaving your team to work from assumptions rather than facts.

While the clinical team adapts quickly to charting and treatment entry, the financial side—how payments are applied, how adjustments are recorded, how deposits reconcile—is far more complex. Without careful audits, errors compound rapidly.

Why Financial Monitoring Must Evolve with New Software

Financial oversight isn’t just about numbers—it’s about how those numbers are created. When you change systems, you also change:

• How payments are applied
• How insurance claims are tracked
• How adjustments are categorized
• How reports are generated and interpreted

Your old reporting habits may no longer reflect the same data logic. Even with training, team members may unknowingly use new tools incorrectly or inconsistently. Without oversight, these small errors accumulate—and in some cases, leave gaps for backdating, unchecked write‑offs, or mismanaged claims.

Times of Change Invite Risk

Transitions create opportunity—not only for improvement but also for exploitation. In nearly every embezzlement investigation I’ve conducted, software changes or leadership distractions were pivotal moments when systems broke down and trust was misplaced.

If a single employee handles posting, adjustments, and deposits without permission settings or regular audit reviews, you’ve opened the door to significant risk.

Critical Areas to Review in Your New Software Setup

If you’ve recently transitioned—or plan to—give focused attention to these areas:

1. Transaction Recording

• Confirm how payments are recorded and posted.
• Ensure EFTs, checks, credit cards, cash, and third‑party financing are accurately categorized.
• Customize entry options to match your deposit methods.

2. Adjustments

• Limit adjustment types and assign them to specific roles.
• Use clear, named adjustments (e.g., Insurance Contractual, Bad Debt, Professional Discount).
• Monitor weekly adjustment reports by user and procedure code.

3. Patient Balances and Ledgers

• Audit migrated balances for accuracy—were credits or balances lost or inflated?
• Review active accounts to confirm balances reflect actual treatment and payments.

4. User Permissions

• Eliminate generic logins; assign unique usernames and review permissions regularly.
• Restrict who can backdate, delete payments, edit insurance plans, or write off balances.
• Require multi‑user approval for refunds or large write‑offs.

5. Daily Close Protocols

• Ensure audit trails are active.
• Review daily reports—do deposits match entries? Are there unexplained changes?
• Implement dual‑check systems with management sign‑off.

The First 90 Days Post‑Conversion: Don’t Let Your Guard Down

Many practices relax too soon after go‑live. Instead, use this window to validate everything:
• Reconcile every deposit against software entries and bank statements.
• Run daily and weekly audits of payments and adjustments.
• Search for old claims left behind in the prior system.
• Verify that posted treatment matches treatment actually completed.
• Identify patient balances that didn’t convert properly.

It’s not uncommon to uncover duplicate accounts, missed balances, or old claim payments posted to the wrong providers—issues that can quietly erode your bottom line.

Keeping Financial Integrity Visible

Your software is the engine of your business—but you must know how to read the dashboard. You don’t need to post payments yourself, but you do need to understand the systems and reports.
• Hold monthly business reviews with your office manager and billing team.
• Request monthly summaries showing production vs. collections, aging, and adjustment trends.
• Require documentation for large write‑offs or refunds.
• Review audit logs for after‑hours edits or high‑volume deletions.

Before You Switch

Many offices explore cloud‑based software to avoid costly server upgrades. Your IT contractor may have quoted thousands to replace hardware, and cloud platforms look attractive. New interfaces and slick marketing often make them irresistible.

But after years of investigating fraud and embezzlement, we know many of these platforms fall far short in financial tracking, reporting clarity, and visibility into payment changes or deletions. They’re fantastic for clinical workflows—sometimes even better for a dishonest front‑office employee than for the owner trying to protect revenue.

Ask these questions before you decide:

• Can the reporting show exactly how much was paid on a specific date—and match those amounts to your bank deposits?
• If a payment type or amount is changed after entry, does the audit trail clearly document it?
• Can you run a report by payment type over a custom date range? For example, if your merchant statement shows $65,395.46 processed in March, can your software confirm that figure?

Our final thoughts…
Upgrading your software doesn’t automatically upgrade your financial integrity. Make financial monitoring and clear protocols a priority during every transition. By establishing audit routines, assigning permissions carefully, and reviewing reports regularly, you protect more than your patients — you protect the profitability and future of your practice.