Minutes
The minutes of the June 19, 2015 meeting were approved.
Presentation of PriceWaterhouseCoopers Audit Report
Mr. Eric Schwartz of PriceWaterhouseCoopers (PwC) provided the Audit Committee with a presentation of the audit of fiscal 2015 consolidated financial statements of Dartmouth Hitchcock-Health and Subsidiaries.
PriceWaterhouseCoopers issued an unmodified opinion on the consolidated financial statements. Areas identified for audit procedures for NLHA include entity level controls, revenue, long-term debt, fixed assets, salaries and benefits and consideration of fraud.
Procedures to validate the existence and valuation of net patient service revenue included agreeing charges to medical records, billing and related cash receipts. No exceptions were noted during testing.
Fixed asset testing involved tracing of fiscal 2015 additions, recalculation of depreciation expense and examination of new leases for proper classification as operating or capital leases. No exceptions were noted.
PwC confirmed 100% of NLHA outstanding debt, tested 2015 debt repayments, and examined debt covenant calculations for accuracy and did not identify any issues.
Procedures for salary and benefits traced data from human resources through to payroll expense for employees selected for audit substantiation. No exceptions were noted.
Management override of controls and risk of fraud for revenue recognition were areas identified as a significant risk for DH-H and all Affiliates.
An implicit theme of this case that I want students to recognize is the contrast between the persistent and vigorous efforts of David Sokol to “get to the bottom” of the suspicious items he uncovered in JWP’s accounting records versus what Judge William Conner referred to as the “spinelessness” of JWP’s auditors. The JWP audits were similar to most problem audits in that the auditors encountered numerous red flags and questionable entries in the client’s accounting records but, for whatever reason, apparently failed to thoroughly investigate those items. On the other hand, Sokol refused to be deterred in his investigation of the troubling accounting issues that he discovered. The relationships that existed between members of JWP’s accounting staff and the Ernst & Young audit team apparently influenced the outcome of the JWP audits. Of course, the Sarbanes-Oxley Act of 2002
Charges – This is the financial obligation made to a patient’s account for services rendered.
The revenue cycle represent the flow of cash from the beginning to end and source. For any business large or small, public or private the revenue cycle is critical. In a hospital setting the revenue cycle begins at the time the patient first presents for treatment and is registered as a patient. This is “depicted within the text in Figure 2-1 as six stages- provide services, document services, establish charge, prepare claim/bill, submit claim and receive payment” (Cleverley, Cleverley, & Song, 2012, p. 14). Accuracy of information entered is paramount because the record created starts is the foundation for all future billing. If the wrong insurance information is documented time is lost on the back end of the cycle contacting the patient to update their
This course is the first in a two-part series that deals with auditing a company 's financial reports, internal controls, and
The qualified opinion report is similar in arrangement to the unqualified report with an additional paragraph dictating the reason the audit report is not unqualified. The third report although rare is an adverse opinion. An adverse opinion report is required when in the auditor’s opinion the financial statements as a whole do not conform to GAAP and are grossly misrepresented. The fourth and final report is a disclaimer of opinion. A disclaimer report is issued when the auditor is unable to gather sufficient information pertaining to the financial reports that an opinion cannot be determined. The auditor’s report has a direct impact on a company’s ability to obtain financing from a bank as the report lowers the cost of capital. The audit report also provides commercial value, meaning it’s an assurance the financial data is true and correct. The independent auditor for Verizon indicates an unqualified opinion in that Verizon’s
13). The clinical services department within the hospital is responsible for the accurate charting of any procedure or service that was provided to the patient. This process begins with patient registration and verification. The healthcare provider then will perform their job as necessary and will indicate what billable tasks were performed which can later be processed. The patient accounts department is responsible for going through the patient’s chart and recording the patient’s bill by use of the hospital’s chargemaster to send the bill to the payer by the health information department. In this department the initial coding of the patient’s medical record is done. Once overviewed for the sake of accuracy, the final coding is done and sent to the payer. Any inaccuracies by any of these departments could directly impact the hospitals reimbursement process through a slowing for the process or simply by failing to bill for a procedure performed, ultimately hurting the hospital’s financial stability. The patient financial services (PFS) department is responsible for ensuring compliance within the billing and coding policies through training and with quality assurance checks and regular audits. This ensures that the revenue and reimbursement cycle continues without any inaccuracies in patient charges. It is especially important to have quality management within this department, as it has the potential to affect the entire organization, reflective of the institutes financial situation. Poor PFS management can lead to a loss in revenue and can lead to a loss in budget if the hospital is losing too much as a result. Ensuring compliance with medical coding and billing guidelines and policies ensures a more accurate representation of the hospitals financial and budgetary situations, while
#2. Internal Control Risks; audit planning decisions. Some internal control risks common among large, high-volume retail stores include dealing with inherent limitations and potential fraud. Even if a well-designed internal control system is in place, the employees using it are ultimately the deciding factors in its effectiveness. For example, management may instruct an employee or easily-influenced executive (of another company) to alter information or confirmations or multiple employees may conspire to steal assets or misstate records (collusion; misappropriation of assets).
Revenue determination is an important tool for health care organizations because it allows for efficient management of payment systems. This paper will look at the different components that form the payment-determination bases of revenue determination. Moreover, the difference between specific and bundled service payments will be discussed. Lastly, the three ways health care providers control their revenue function will be highlighted.
It was believed that Johnson conducted all audits in accordance with the PCAOB standards for the 2012 and 2013 year-end financial statements. Unqualified opinions that were issued were done in two different forms: 10-K and S-1. Six of the clients were affected by the unqualified opinion, and the other two clients had issues with the registration statements.
| The objectives are (1) audit of KCN’s financial statements for the year ended 12/31/05, and (2) issuance of a letter on compliance with covenants of the client’s letter of credit agreement.
Risk for inflated revenue and net income, revenue being recognized when received instead of when earned.
Fraud Risk: These weakness affects all levels of the internal control environment and other areas of the company. It shows that internal controls are not as important as meeting the company’s performance outlooks. If management does not openly display ethical conduct, the expectation of fraud and misappropriation
For nonpublic companies auditing guidance are issued by the American Institute of Certified Public Accountants, AICPA. Prior to PCAOB, AICPA served as the primary governing body of public accounting profession. Since the roles have changed with PCAOB regarding the auditing standards for public companies, the AICPA is still developing standards for the nonpublic companies. The organization has developed four fundamental principles that govern an audit conducted in accordance with GAAP. The principles are:
The personnel and payroll cycle includes the hiring of employees, recording hours worked, withholding and, recording of taxes, distributing payment for work performed, and properly documenting the termination of employees. Payroll can be a significant expense for a company and without proper internal controls can be vulnerable to fraud. Some common types of the fraud within the payroll cycle consist of ghost employees, claiming unworked hours, and pay rate alteration. The objective of a payroll audit is to determine if the current balances in the audit period are fairly stated and in accordance with accounting principles. According Arens, Elder, and Beasley, “Tests of controls and substantive tests of transactions procedures are the most important means of verifying account balances in the payroll and personnel cycle” (2012, p. 664). An
Based on the financial ratios given, this section will compare and contrast the financial strengths of Company X and Company Y in order to suggest Tringale Ltd to take decision regarding which of the above companies to chose for investment. This section provides comments on financial performance areas based on the data given, and presents report to the Board of Directors of Tringale Ltd by recommending which of the two investment opportunities is better.