Fraud Risk Assessment & Investigation

Phase I – Assessment

• Assess the current and historic accounting records available to understand balance sheet accounts as well as cash flow. If records are unavailable or incomplete, we will recreate records based on bank account statements. 

• Perform data analytics using computer assisted audit techniques (CAAT). We use CAAT routines to evaluate financial transactions and a tiered-exception filtering process whereby we first exclude transactions most likely to be properly recorded, and successively isolate categories and classes of transactions susceptible to mis-recording, manipulation, or fraud. 

• Identify one or more groups of transactions warranting further investigation. We will discuss with you the investigative procedures to be applied. 

Phase II – Investigation 

Implement investigative steps based upon the information obtained and patterns identified in Phase I. The specific steps will depend on the Phase I results; however, the following types of procedures may apply: 

• Following transaction postings from sub-systems to the general ledger. 

• Reviewing supporting documentation such as correspondence, scheduling events, emails, system authorizations, bank records, control logs, and tax returns. 

• Identifying the individual(s) whose work affected the exception transactions; identify other areas of custodianship and reporting accessible by this person(s). 

Phase III – Preliminary conclusion and follow-on procedures

• Quantify any errors, irregularities, or identified mis-reported results.  

• Identify whether any records or other input from outside sources (e.g., vendors, financial institutions, intermediaries, customers/patients) is required to be able to conclusively resolve the noted exceptions.  

• Consult with you about whether to pursue outside input and the advisability of retaining legal counsel.

Phase IV – Reporting & Beyond

Present our findings as a written report describing the nature of our engagement, procedures performed, and findings. Our team provides support for all levels of investigations up to and including claim documentation and, if required, through judicial and legal processes.