To: Dr. Peggy Hart, Optometrist, Good Neighbor Clinic

Assoc Dean Roger Boltz

Date: September 1997

Re: Good Neighbor Receipts Policy and Procedure

POLICY

The College of Optometry has a Good Neighbor Clinic Receipts Policy to minimize losses to the University’s monetary assets. It is the responsibility of University of Houston employees to secure and account for the University’s monetary assets and prevent any loss of funds. The Good Neighbor Clinic Director’s designee must balance each day’s financial activity at the end of the day using the appropriate forms and procedures. This policy will be reviewed yearly and/or revised as needed.

PROCEDURES

  1. Each patient entering the clinic is issued a super bill that is consecutively numbered. The receptionist writes the patient’s name on a numbered daily log (see attached) where the super bill is recorded.
  2. After services are rendered, the fee statement is prepared by the attending doctor.
  3. Fees are collected by the receptionist and recorded on the daily log. The patient account is logged into the computer with the appropraite charges and payments.
  4. Before the patient leaves the clinic, the attending doctor signs the fee statement and checks the transaction on the daily log.
  5. Cash and checks are kept in a cash register on the desk of the receptionist. The cash register is locked at lunch and when the receptionist leaves his/her work area.
  6. Income is balanced once per day, at the end of the business day, against the daily log and day sheet. Cash register and cash/checks are reconciled using "Check Out Sheet" (see attached).
  7. The individual counting the income may vary from day to day and is assigned by the attending doctor.
  8. The daily log, yellow copy of the superbills, income, Medicare/Medicaid forms and cash register tape is placed in a money bag and sealed. A transmittal form is prepared for UH Police’s signature upon pickup.
  9. The locked cash bag and transmittal form is picked up at 4:45 PM by UH Police. Good Neighbor’s doors close promptly at 5:00. If deposit has not been picked up by 5:00, lock and secure the funds in the clinic.
  10. The locked cash bag is placed in the night deposit at Sterling Bank by UH Police.
  11. The locked cash bag is delivered the next business morning by the UH Police to the Optometry Clinic Business where the funds are deposited with other clinic income by the Business Office supervisor.

Dean Jerald W. Strickland Mary A. Juarez, College Business Admin