the company you work for does medical insurance billing payments processing and reconciliation u

Name: the company you work for does medical insurance billing payments processing and reconciliation using both web based transaction systems as well as batch file processing of hundreds of transa 66598
Uploaded: 2024-03-10T16:15:36-08:00
Duration: 3 min 42 s
Channel: Shu Naito
Description: the company you work for does medical insurance billing payments processing and reconciliation using both web based transaction systems as well as batch file processing of hundreds of transa 66598

Step 1: Identify the key components of the current backup and restore strategies. This includes

The company you work for does medical insurance billing...

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The chief financial officer(CFO) made some complaints to the CEO regarding capital expenditures for security software. You try to lighten the blow by explaining the value of controlling security. In a point paper to the CEO, explain the cost benefit analysis method you use to do a quantitative assessment before investing in a security control. Complete and include table below in your paper Historical PCS incidents, cost per incident, frequency of occurrence, LLE, ARO, ALE theft of information (hacker) 25,500 once every 5 years frequency of occurrence Sle 25,500 ARO 2 theft of information (employee) cost per incident 50,000 once every 2 year’s frequency of occurrence sle 50,000 ARO 3 web defacement 500 cost per incident once per month ARO 12.0 ale 6,000 theft of equipment 5,000 cost per incident once per year ARO 1.0 ale 5,000 virus, worms, Trojan horses 1,500 cost per incident sle 1,500 ARO 52.0 ale78,000 denial-of-service attacks 2,500 cost per incident sle 2,500 ARO 4.0 ale 10,000 you are currently deciding whether to invest in data loss prevention software. You have some reliable statistics that the software will reduce your information theft incidents by half of the current values. The cost of the software is $ 100k per year . Recalculate the new ARO and ALE for hacker and employee information theft based on these new values explain your decision whether or not to invest in the data loss prevention software projected PCs incidents with data theft prevention software theft of information ( hacker) cost per incident 25,500 frequency of occurrence once every 5 years sle 25, 500 theft of information ( employee) 50,000 frequency of occurrence once every 2 years sle 50,000

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Discuss the benefits that may be realized in switching from a computerized batch processing system to a direct access storage system. Also, discuss any additional control implications.

Nick J.

Goodfellow & Perkins gained a new client, Brookwood Pines Hospital (BPH), a private, not-for-profit hospital. The fiscal year-end for Brookwood Pines is June 30. You are performing the audit for the 2023 fiscal year-end, and the audit is currently in the risk assessment phase. The healthcare industry can be very complicated, especially in the area of billing for services provided. BPH contracts with private physician groups who use the hospital facilities, equipment, and nursing staff to treat patients. The physicians in the private group are not employees of the hospital; they are simply using the hospital facilities to treat patients. For example, a group of urologists has their own practice, separate from the hospital, where they treat their patients. If one of their patients needs a surgical procedure that must be done at a hospital, then the attending urologist will approve the paperwork required to admit the patient to BPH. BPH offers inducements to the urologists so they will refer patients to BPH rather than a competing hospital. One of the inducements BPH offers is free office space in the hospital for the doctors to use when they are treating their patients in the hospital. After the doctor and hospital services are provided to the patient, the patient and/or the patient's insurance company is billed. The doctor will bill for the services he or she provided, and the hospital will bill for the use of hospital facilities and staff. Doctors and hospitals bill using a coding system that is standardized across the healthcare industry and consists of three main code sets: ICD, CPT, and HCPCS. Using a coding system is more efficient and data-friendly compared to writing a narrative about the procedures performed. However, the coding system is very complex, with thousands of different codes for medical procedures and diagnoses. To complicate matters even more, for patients who are covered by government-sponsored Medicare or Medicaid, doctors and hospitals must adhere to complicated government regulations surrounding billings to Medicare and Medicaid. As healthcare costs continue to rise each year, BPH administrators struggle to maintain consistent profitability. They look for ways to keep costs low and also to collect from patients and insurance companies as quickly as possible. In addition, BPH must have a strong risk management team to handle unique situations that may occur in hospitals such as malpractice lawsuits and periodic inspections by the state department of health and hospitals. Negative publicity for BPH could lead to decreased revenues if physicians decide to contract with a competing hospital. Evaluating internal control Analysis: Brookwood Pines has a large number of employees, and it is important for the payroll system to have controls to ensure that employees actually worked the hours they are paid for. Answer the following items: a. Determine the key assertion at risk. b. Describe a practical preventive internal control that would directly address the risk. c. Describe a practical detective internal control that would directly address the risk. d. Explain the test of controls you would perform to test the control in your answer to (b), including the evidence that you would obtain. e. Describe the evidence of an exception to the internal control in your answer to (b). f. Explain the test of controls you would perform to test the control in your answer to (c), including the evidence that you would obtain. g. Describe the evidence of an exception to the internal control in your answer to (c).

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Transcript

00:01 So we can use a cost -benefit analysis or cba method focusing on historical pre -control scenario incidents, including their cost -per -incident frequency of occurrences and single -loss expectancy, annual rate of occurrence, and annual loss expectancy.

00:32 Here is the summary table of historical pcs incidents and their respective financial impacts.

00:44 The introduction of data loss prevention software is expected to reduce the frequency of information theft incidents by half.

00:54 Here is the recalculated aro and ale for these incidents.

01:02 Now, the annual cost of the data loss prevention software is $100 ,000.

01:09 The expected reduction in ale for theft of information by hackers and employees combined is… so, the original ale is hacker plus employee, so that would be 5100 plus 25 ,000 or $3100...

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