Phase 2 Planning Due: 18 May 2013 Required: Given the details established in phase 1 (Instigation) and further details below you are required to prepare a 1-2 page document stating your investigative hypothesis and then deduce your strategy for proving/denying your hypothesis. Your deduction should include a table with three columns stating the information you propose to review‚ where the data would be found and what you are specifically looking for in analysing the data. Information – what
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Health Care Fraud 1. Types of Health Care Fraud A. Health insurance B. Drug Fraud C. Punishment 2. Entities involved in Health care fraud A. Social a. Individuals B. Political a. Oversight b. Supreme Court input C. Cultural 3. Technology and health Care Fraud A. Billing Procedures B. Unbundling 4. Ethics involved with Fraud/Economic Impact a. Effects on Health Care b. Monitor outgoing monies
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Proactive Fraud Auditing End of Chapter 4 in Albrecht FRAUD DETECTION Recognizing the Symptoms of Fraud Identify Risk Exposures Proactively Look for Symptoms & Exposures 1 2 Actg 537 Identify Fraud Symptoms for Each Exposure 3 4 Investigate Identified Symptoms Symptoms of Fraud What are some irregularities in source documents to look for? Missing Documents Payee Names & Addresses = Employee “Stale Items” on Bank Items” Reconciliation Excessive Voids or Credits
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The Global Fraud Survey not only provides information about different types of frauds schemes and characteristics of fraud perpetrators but also provide a deep insight into the red flags associated with it. According to Survey‚ Two thirds of frauds were committed by males‚ between the age of 31 and 45‚ and male perpetrators have caused twice the loss as compared to women perpetrators. According to the article‚ only 7% of fraud perpetrators had previously been convicted or charged with fraudulent
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EXECUTIVE SUMMARY “Rising frauds lead to greater operational threat.” Insurance is one of the tools for risk management that aims at reducing the risk on the day-to-day life of individuals‚ organisation and society. At the same time‚ it should also be appreciated that insurance cannot be utilised as a risk free tool for all types of situations. Insurance provides risk management solutions to many situations that fall within the competence of human judgement and managerial skills. Insurance is
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bring people together by extending the already diverse and complex ties that people have among themselves.” The Internet technology connects almost everyone‚ but it also has its complications. This paper focuses on one main problem Internet users may encounter. It is limited through certain books‚ dictionaries‚ and internet sources that are accessible. The writer used books for facts and figures‚ dictionaries for descriptive purposes‚ and credible online sources such as the United States Department
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more basic concepts in fraud deterrence and detection is the fraud triangle. The fraud triangle is also known as Cressey’s Triangle‚ or Cressey’s Fraud Triangle. Cressey’s Fraud Triangle gets its name from Donald Cressey. Cressey was one of the “nations leading experts on the sociology of crime”. He authored a few books including Other People’s Money‚ Theft of the Nation‚ and co-authored Principles of Criminology with Edwin H. Sutherland. Cressey is honored by many anti-fraud organizations‚ including
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HealthSouth Fraud Investigation Table of Contents Table of Contents i Introduction and Background 1 Analysis 1 Why it occurred 2 Fraud Triangle 2 How it occurred 3 Red Flags of the Fraud 5 Why the Fraud Continued Undetected 6 The Auditors Roles and Responsibilities 7 Fate of Parties Involved 8 Effect of Fraud on HealthSouth 9 Conclusion 10 Appendix A 11 Appendix B 12 Appendix C 13 Appendix D 14 Appendix E 15 Appendix F 16 Works Cited 17 Introduction and
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Computer fraud is the use of information technology to commit fraud. In the United States‚ computer fraud is specifically proscribed by the Computer Fraud and Abuse Act‚ which provides for jail time and fines. 1. Unauthorized access at North Bay Abdulswamad Nino Macapayad‚ a former accounts payable clerk for North Bay Health Care Group‚ admitted to using her computer to access North Bay’s accounting software without authorization‚ and in turn issued various checks payable to herself and others.
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Corporate Fraud I. Introductions a. Fraud in the accounting environment is on the increase. b. Fraud takes place in different forms in the accounting environment. II. The growing risk of fraud and corruption a. Local problems‚ global pain b. Awareness is crucial c. Tailoring efforts to avert damage III. Preventing Fraud a. Background checks and enhanced due diligence b. Monitoring and evaluating preventive controls c. Continuous controls monitoring IV. Can we eliminate fraud and corruption
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