In Part One, I shared how relying only on bank deposits is like finishing a puzzle without all the pieces. You see part of the picture, but not enough to know if it’s accurate. For many practices, that incomplete view is exactly what creates the risk for embezzlement.
But there’s another missing piece I want to talk about: the role of your CPA.
The CPA Disconnect
Too often, dentists assume their CPA is watching over everything. After all, isn’t that why you hire a CPA—to make sure the numbers are accurate?
Here’s the hard truth: many CPAs only focus on what flows through the bank and into the accounting software. They don’t ask for practice management reports. They don’t schedule quarterly calls to walk through anomalies. And they don’t press for answers when something doesn’t make sense.
The result? Another gaping blind spot.
A Real-Life Example
Years ago, I investigated a $1.1 million embezzlement case that stretched over ten years. It could have been caught early—easily—if just a few protocols had been in place.
Here’s how it unfolded:
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A bookkeeper entered deposit information into the accounting software from the deposit reports she was given.
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The person preparing those deposit reports? The embezzler.
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The CPA never once asked for a date range report from the practice software to confirm monthly deposit totals.
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The Reality? If the CPA had actually asked for that report, it would have been the embezzler who “created” it—showing how dangerous it is to rely on only one person without oversight.
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The CPA’s entire focus was taxes, not oversight. He never even thought to compare the practice management reports with the accounting software.
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The dentist believed—and trusted—that if something was happening, the bookkeeper and CPA would catch it.
When I completed my investigation, I had the opportunity to meet with the CPA. I asked why he never asked for practice management reports. His response stunned me:
“This is the only one of my clients that has ever been embezzled.”
I couldn’t stay silent. I replied:
“How would you ever know? I’m the one who brought this to your attention. You didn’t discover it.”
That’s the danger. When CPAs don’t request the right reports—or don’t understand dentistry—they miss the very things they are believed to be safeguarding.
Why Dentistry Is Different
To be fair, many CPAs work across multiple industries. But dentistry is unique. Between insurance reimbursements, adjustments, fee schedules, and patient collections, there are multiple layers that don’t show up in a bank statement alone.
A CPA who understands dentistry knows how to:
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Compare collections reports from the practice software with deposits in the accounting software.
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Look for anomalies in adjustments, refunds, and write-offs.
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Spot unusual trends in production vs. deposits.
- Spot unusual trends in purchases.
Without those reviews, deposits can look “normal” while hiding hundreds of thousands of dollars in theft or errors.
What Accountability Looks Like
A truly supportive CPA is more than a tax preparer. They’re a partner in accountability. Here’s what that looks like:
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Quarterly calls with the doctor to review reports and answer questions.
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Requesting practice management reports alongside bank and AP data.
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Clarifying anomalies instead of glossing over them, or ignoring them.
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Industry-specific knowledge so they can spot trends unique to dentistry.
Yes, dental-specific CPAs may cost more. But in my experience, they’re worth every penny—because they know what to look for and how to connect the pieces.
Closing Thought
Oversight isn’t optional. You can have every puzzle piece sitting on the table—AR software, AP software, bookkeepers, CPAs—but if no one connects them, the picture is still incomplete.
Dentists, don’t assume your CPA is putting the puzzle together for you. Ask questions. Provide reports. Expect accountability. And if your CPA isn’t engaged in that process, it may be time to find one who is.
But if you truly enjoy working with your CPA and want to keep that relationship, you don’t have to choose between loyalty and accountability. That’s where my Quarterly Integrity Oversight service comes in. I work alongside your CPA to ensure both your practice management and accounting software align, bridging the gap so nothing slips through the cracks.
Because your practice deserves more than partial oversight—it deserves a complete picture.