Defraugh University Hospital
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Feb 20, 2024
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DEFRAUGH UNIVERSITY HOSPITAL
Kelly Buynoch
WHAT HAPPENED
Defraugh University Hospital has been accused of fraudulent activity.
Defraugh University Hospital is being accused of taking Medicare payments in the amount of $1M after Medicare already paid the hospital for their services. This does not include the payments from the patients that made their accounts “paid in full”.
The next three slides will give the public information on how Defraugh University Hospital is handling this situation. 20XX
2
IN LIGHT OF THESE EVENTS, THE FOLLOWING PROCEDURES WILL BE CHANGED:
1. We will implement a new compliance program. This will help staff detect and prevent this type of fraud. Compliance programs help our facility comply with the laws and regulations and improve billing processes.
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Related Questions
22
The following transactions are exempt from VAT, except:
Group of answer choices
Importation of prescription drugs for diabetes, high cholesterol, and hypertension.
Salary paid by a hospital to a registered medical technologist who performed laboratory services for inpatients.
Sale of cough syrup by the pharmacy of a hospital to outpatients.
Sale of prescription drugs for cancer, mental illness, tuberculosis and kidney diseases.
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1. FRAUD SCHEME HEALTH
INSPECTOR
A city health inspector threatens to close down a restau-
rant by issuing a fake health violation notice if the owner
does not make a financial payment to the inspector. If
the restaurant owner does not cooperate, he will not be
able to open for business and the publicity will drive
away his customers permanently. Faced with a threat
of economic loss, the owner makes the payment.
Required
What type of fraud is this, and what controls can be
implemented to prevent or detect the fraud?
arrow_forward
Chapter 15 Please remember that you must do your own work. Any plagiarism will result in a grade of zero for all students involved. Please use your own words even if you are using the textbook for answers. Always provide a citation when a reference is used. The purpose of deductibles in property insurance policies is to reduce the number of small claims that are costly to adjust and provide claims service. The purpose of deductibles and coinsurance in health insurance is quite different. Discuss the purpose of deductibles and coinsurance in health insurance and the need for insureds to share in those types of costs. A. Describe a person (individual or family) who would likely benefit from establishing a health savings account (HAS) B. Briefly explain the major characteristics of a health savings account (HSA). A. Explain the following renewal provisions that may appear in individual health insurance policies: Guaranteed renewable: Noncancelable: Conditionally renewable:…
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Please solve the question with a detailed explanation.
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FRAUD SCHEME - HEALTH INSPECTORA city health inspector threatens to close down a restaurant by issuing afake health violation notice if the owner does not make a financial
payment to the inspector. If the restaurant owner does not cooperate, hewill not be able to open for business and the publicity will drive away hiscustomers permanently. Faced with a threat of economic loss, the ownermakes the payment.
RequiredWhat type of fraud is this, and what controls can be implemented toprevent or detect the fraud?
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J. Explanation of Benefits
XYZ Insurance Company Explanation of Benefits
Walden-Martin Family Medical Clinic
1234 Anystreet
Anytown, AK 12345-1234
Patient Treatment CPT
Name
Dates
Code
Yan, Tai 01/06/20XX (99205
01/06/20XX
01/06/20XX
Totals
Gomez, 01/07/20XX
Pedro
Totals
82947
86580
99212
*
Amount
Charge Reason Covered Deductible Co-Pay
Code Amount Amount Amount Paid At
132.28
03
15.00
11.34
158.62
28.55
28.55
70.92
01/04/20XX 71020
Totals
Green, 01/04/20XX 99203
Jana
40.97
111.89
Reason Code: 03 Allowed amount per insurance contract
03
03
125.00
15.00
11.34
151.34
28.55
28.55
69.23
34.95
104.18
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Copyright © 2020, Elsevier Inc. All Rights Reserved.
80%
80%
80%
0.00 80%
0.00 80%
0.00 80%
01/20/20XX
Payment
Amount
100.00
12.00
9.07
121.07
22.84
22.84
55.38
27.96
83.34
Check No: 56390 $227.25
Using the explanation above answer the following questions:
1. For Tai Yan's office visit, 99205, there is a difference between the Charge Amount and…
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Concerning revenue (receipt), each of the department has cash till for receiving patients' payments. Patients of WeCare Sdn Bhd can pay either in cash or using their credit card. Each department has one account clerk that maintains the revenue that comes into the department. The accounting clerk raises sales invoices, process payment, and receives payment upon receiving an advice note from the employee that provides the service. The design of the sales system is such that the system automatically generates the bill for each patient. The head of departments close the tills at the close of work each day and record and perform the reconciliation of cash receipt and credit card voucher with the total daily reading of revenue receipt generated from the till. A significant portion of WeCare Sdn Bhd patient uses cash as a medium of payment. The head of each department keeps all cash receipt in a password locked safe. The password of the safe is only known to the departmental heads. Cash…
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Petty Cash Fund
Note:-
Do not provide handwritten solution. Maintain accuracy and quality in your answer. Take care of plagiarism.
Answer completely.
You will get up vote for sure.
arrow_forward
Solve the problem
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Credit Card Fraud and Identity Theft
Loss of a credit card, the information on it, or your personal information can cause serious
problems. For example, you could be required to pay for purchases you didn't make, or you could
spend years repairing the damage to your credit rating.
Consider the following two alternative behaviors.
Behavior
A If I receive an e-mail with a sales offer I like, rather than
provide my account number through the e-mail link, I open
a separate browser window and directly access the
company's website to make my purchase.
B
I save all my charge receipts and reconcile them to my
monthly statement, most often by accessing my account
online.
Which behavior is likely to reduce your chance of experiencing credit card fraud or identity theft?
O Alternative A
O Alternative B
Both Alternatives A and B
ONeither Alternative A nor B
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Prepare a classified balance sheet
Be careful as this is a classified financial statement
All accounts may not be used
Third party revenue
$6,100,000.00
Patient receivable
$10,350,000.00
Accounts Receivable
$1,400,000.00
Cash
$50,000,000.00
Insurance expense
$3,687,000.00
Mortgage Payable
$12,630,000.00
Mortgage Payable- Current
$1,100,000.00
Inventory (asset)
$7,800,000.00
Wages Payable
$3,900,000.00
Wage Expense
$2,700,000.00
Inventory expense
$4,650,000.00
Plant and Equipment
$41,700,000.00
Accounts Payable
$18,300,000.00
Supplies Payable
$8,175,000.00
Medical Supplies
$12,300,000.00
Medical Supply Expense
$2,943,000.00
Net Assets without donor restrictions
$17,693,000.00
Net assets with donor restrictions
???????????
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How do I solve E9-15
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e https://newconnect.mheducation.com/flow/connect.html
X e ezto.mheducation.com
e ezto.mheducation.com
e Portal
eChapter 9 Problems
Saved
Chapter 9 Problems i
Scott Duffney, CPA, has randomly selected and audited a sample of 100 of Will-Mart's accounts receivable. Will-Mart has 3,000
accounts receivable accounts with a total book value of $3.600,000. Duffney has determined that the account's tolerable
misstatement is $850,000.
polnts
His sample results are as follows:
Average audited
value
$1,190
eBook
Average book value
1,198
Print
Required:
Calculate the accounts receivable estimated audited value and projected misstatement using the: (Do not round your intermediate
calculations and round your final answer to nearest whole dollar.)
References
Estimated
Audited Value
Projected
Misstatement
a. Mean-per-unit method.
3,570,000 $
30,000
b. Ratio method.
C.
Difference method.
Mc
Graw
Hill
Education
Chapter 9 Problem...
DELL
%24
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A small medical supply company sells cash only the cash sale procedure involves several steps• The sales clerk prepares a pre-numbered sales invoice in triplicate. The sales clerk takes copy 1 and 2 together with the payment and present them to the cashier• The cashier validates the original copy and gives it to the customer• The third copy of the sales invoice stays in the invoice book when the invoice book has been depleted all 3rd copy of the invoices is filed in the sales office. “by invoice books”• At the end of each day the cashier prepares a Sales summary, a deposit slip in duplicate and counts the cash. He or she takes the cash to the Bank and deposit it. The cashier retains a copy of the deposit slip the other copy is validated by the bank.• The cashier then gives the accountant the sales summary, the 2nd copy of the invoices and the validated deposit slip.• The accountant agrees the numbers prepare the journal entryFiles the documents as followsSales summaries by dateInvoices…
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Helpl
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SEE MORE QUESTIONS
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Related Questions
- 22 The following transactions are exempt from VAT, except: Group of answer choices Importation of prescription drugs for diabetes, high cholesterol, and hypertension. Salary paid by a hospital to a registered medical technologist who performed laboratory services for inpatients. Sale of cough syrup by the pharmacy of a hospital to outpatients. Sale of prescription drugs for cancer, mental illness, tuberculosis and kidney diseases.arrow_forward1. FRAUD SCHEME HEALTH INSPECTOR A city health inspector threatens to close down a restau- rant by issuing a fake health violation notice if the owner does not make a financial payment to the inspector. If the restaurant owner does not cooperate, he will not be able to open for business and the publicity will drive away his customers permanently. Faced with a threat of economic loss, the owner makes the payment. Required What type of fraud is this, and what controls can be implemented to prevent or detect the fraud?arrow_forwardChapter 15 Please remember that you must do your own work. Any plagiarism will result in a grade of zero for all students involved. Please use your own words even if you are using the textbook for answers. Always provide a citation when a reference is used. The purpose of deductibles in property insurance policies is to reduce the number of small claims that are costly to adjust and provide claims service. The purpose of deductibles and coinsurance in health insurance is quite different. Discuss the purpose of deductibles and coinsurance in health insurance and the need for insureds to share in those types of costs. A. Describe a person (individual or family) who would likely benefit from establishing a health savings account (HAS) B. Briefly explain the major characteristics of a health savings account (HSA). A. Explain the following renewal provisions that may appear in individual health insurance policies: Guaranteed renewable: Noncancelable: Conditionally renewable:…arrow_forward
- Please solve the question with a detailed explanation.arrow_forwardFRAUD SCHEME - HEALTH INSPECTORA city health inspector threatens to close down a restaurant by issuing afake health violation notice if the owner does not make a financial payment to the inspector. If the restaurant owner does not cooperate, hewill not be able to open for business and the publicity will drive away hiscustomers permanently. Faced with a threat of economic loss, the ownermakes the payment. RequiredWhat type of fraud is this, and what controls can be implemented toprevent or detect the fraud?arrow_forwardJ. Explanation of Benefits XYZ Insurance Company Explanation of Benefits Walden-Martin Family Medical Clinic 1234 Anystreet Anytown, AK 12345-1234 Patient Treatment CPT Name Dates Code Yan, Tai 01/06/20XX (99205 01/06/20XX 01/06/20XX Totals Gomez, 01/07/20XX Pedro Totals 82947 86580 99212 * Amount Charge Reason Covered Deductible Co-Pay Code Amount Amount Amount Paid At 132.28 03 15.00 11.34 158.62 28.55 28.55 70.92 01/04/20XX 71020 Totals Green, 01/04/20XX 99203 Jana 40.97 111.89 Reason Code: 03 Allowed amount per insurance contract 03 03 125.00 15.00 11.34 151.34 28.55 28.55 69.23 34.95 104.18 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Copyright © 2020, Elsevier Inc. All Rights Reserved. 80% 80% 80% 0.00 80% 0.00 80% 0.00 80% 01/20/20XX Payment Amount 100.00 12.00 9.07 121.07 22.84 22.84 55.38 27.96 83.34 Check No: 56390 $227.25 Using the explanation above answer the following questions: 1. For Tai Yan's office visit, 99205, there is a difference between the Charge Amount and…arrow_forward
- Concerning revenue (receipt), each of the department has cash till for receiving patients' payments. Patients of WeCare Sdn Bhd can pay either in cash or using their credit card. Each department has one account clerk that maintains the revenue that comes into the department. The accounting clerk raises sales invoices, process payment, and receives payment upon receiving an advice note from the employee that provides the service. The design of the sales system is such that the system automatically generates the bill for each patient. The head of departments close the tills at the close of work each day and record and perform the reconciliation of cash receipt and credit card voucher with the total daily reading of revenue receipt generated from the till. A significant portion of WeCare Sdn Bhd patient uses cash as a medium of payment. The head of each department keeps all cash receipt in a password locked safe. The password of the safe is only known to the departmental heads. Cash…arrow_forwardPetty Cash Fund Note:- Do not provide handwritten solution. Maintain accuracy and quality in your answer. Take care of plagiarism. Answer completely. You will get up vote for sure.arrow_forwardSolve the problemarrow_forward
- Credit Card Fraud and Identity Theft Loss of a credit card, the information on it, or your personal information can cause serious problems. For example, you could be required to pay for purchases you didn't make, or you could spend years repairing the damage to your credit rating. Consider the following two alternative behaviors. Behavior A If I receive an e-mail with a sales offer I like, rather than provide my account number through the e-mail link, I open a separate browser window and directly access the company's website to make my purchase. B I save all my charge receipts and reconcile them to my monthly statement, most often by accessing my account online. Which behavior is likely to reduce your chance of experiencing credit card fraud or identity theft? O Alternative A O Alternative B Both Alternatives A and B ONeither Alternative A nor Barrow_forwardPrepare a classified balance sheet Be careful as this is a classified financial statement All accounts may not be used Third party revenue $6,100,000.00 Patient receivable $10,350,000.00 Accounts Receivable $1,400,000.00 Cash $50,000,000.00 Insurance expense $3,687,000.00 Mortgage Payable $12,630,000.00 Mortgage Payable- Current $1,100,000.00 Inventory (asset) $7,800,000.00 Wages Payable $3,900,000.00 Wage Expense $2,700,000.00 Inventory expense $4,650,000.00 Plant and Equipment $41,700,000.00 Accounts Payable $18,300,000.00 Supplies Payable $8,175,000.00 Medical Supplies $12,300,000.00 Medical Supply Expense $2,943,000.00 Net Assets without donor restrictions $17,693,000.00 Net assets with donor restrictions ???????????arrow_forwardHow do I solve E9-15arrow_forward
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Recommended textbooks for you
- Individual Income TaxesAccountingISBN:9780357109731Author:HoffmanPublisher:CENGAGE LEARNING - CONSIGNMENTAccounting Information SystemsFinanceISBN:9781337552127Author:Ulric J. Gelinas, Richard B. Dull, Patrick Wheeler, Mary Callahan HillPublisher:Cengage LearningAuditing: A Risk Based-Approach (MindTap Course L...AccountingISBN:9781337619455Author:Karla M Johnstone, Audrey A. Gramling, Larry E. RittenbergPublisher:Cengage Learning
- Century 21 Accounting Multicolumn JournalAccountingISBN:9781337679503Author:GilbertsonPublisher:Cengage
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Accounting
ISBN:9780357109731
Author:Hoffman
Publisher:CENGAGE LEARNING - CONSIGNMENT
Accounting Information Systems
Finance
ISBN:9781337552127
Author:Ulric J. Gelinas, Richard B. Dull, Patrick Wheeler, Mary Callahan Hill
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Accounting
ISBN:9781337619455
Author:Karla M Johnstone, Audrey A. Gramling, Larry E. Rittenberg
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ISBN:9781337679503
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