Audit Consultant

The topic of the report is an exploration of a career option and a Tax Auditor at Canada Revenue Agency. The purposes of this report are to not only prepare myself for the position by examining and learning but also introduce a different field of work to colleagues

This paper is going to focus on the importance of getting a better way for Medicare to handle the needs of transplant patients. The current situation isn’t a good one. The patients are the ones that suffer while the medical insurance companies and centers keep making more and more money. This is showing to me how much of the healthcare has turned to be about that. The transplant centers are needed but there is so much red tape that they have to go through to be approved by Medicare it makes it hard for them to open. What seems like should be an easy fix sure isn’t when you look into it.

Internal Processes * Qualify for a Patient Centered Medical Home (PCMH) * Communications – (entire staff) – with a quarterly staff meeting * Improve comfort levels with ICD-10 diagnosis coding

Experienced in resolving customer issues and providing information to the patients, family members and staff in a professional manner and adhering to HIPPA protocols; review, analyze and implement a variety of federal regulations as they pertain to the position.

Process of transplantation: “patient is identified as ill and organ failing, doctor assesses if eligible for transplant” (Ethics of Organ Transplantation, 2004, p. 6). “If so, doctor refers patient to local transplant center to be placed on the list” (Ethics of Organ Transplantation, 2004, p. 6). “The transplant center evaluates the patient’s health and mental status as well as the level of social support to see if the person is a viable candidate” (Ethics of Organ Transplantation, 2004, p. 6). “Organs can come from recently deceased people, cadavers, or living persons” (Ethics of Organ Transplantation, 2004, p. 6). “The waiting list for donors is maintained by the United Network for Organ Sharing (UNOS)” (Ethics of Organ Transplantation, 2004, p. 6). Now that I’ve set the basic principle for what an organ transplant

In order for transplants to be successful, there are steps that should be followed. From the beginning, the correct information should be given prior to

Second, legislative initiatives gained ground leading to case management being considered as a primary way of integrating services. Third, employers began creating case management programs for medical claims aimed at cost containment. Fourth, the rise of chronic illnesses as a leading health problem made the coordination of multiple systems of care a necessity. Finally, acute illness prevention efforts can be coordinated by case management providers (as cited in Corcoran & Roberts, 2015, p. 867).

The role of a case manager can include conducting assessments of the patient’s health, planning with others to maximize outcomes, facilitating communication with the whole team, and educating the patient about resources and insurance benefits. They may also empower the patient to problem solve, act as a patient advocate, and assist the patient in transitioning (Case Management Society of America (CMSA), 2010). In Stacey’s case, she has the job of utilization review and discharge planning. For utilization review, she reviews patient’s charts in order to justify why they are in the hospital to the insurance company. It is her responsibility to make sure that the patient is in the right status, whether inpatient or outpatient, to maximize insurance billing. She also gets authorization for expensive medications that the patient might need.

The purpose of Part 1 is to perform preliminary analytical procedures. You have been asked to focus your attention on two purposes of analytical procedures:

The general allocation policies of organ transplants starts with the waiting list process. The donor recipient must do a series of tests required for the transplant of an organ, the results will be entered into the UNOS computer system. The UNOS computer system will match the deceased donors to the recipients by comparing the HLA (human leukocyte antigen) and the computer will show a “match list” that will be based on the number of antigens matching and the antibody levels of the recipient. The length of time the recipient has been on the waiting list is also taken into

claims management team has over twenty years of experience adjusting workers’ compensation claims, while their claim staff averages fifteen years of claims experience. MEM’s claims operation is appropriately staffed and their caseloads are ideal, averaging 118 claims per claim representative. The claim supervisors’ have no working

4. What role does a physician play in this context? How much detailing effort is necessary?

Billing/Accounting personnel: patient demographics, clinical information including diagnosis, treatment and other relevant details related to specific encounter as needed to resolve reimbursement or other patient account questions or issues and chart when necessary to determine diagnosis or

Advance in technology, globalization and internationalization are affecting the method organizations are conducting businesses in the contemporary business environment. Changes in the method that organizations employ in conducting business also increase the danger of fraudulent financial reporting. Financial failures and high profile scandals within business environment between 2000 and 2002 have necessitated market regulators to call for scrutiny in the corporate financial reporting in the United States. The occurrence of fraudulent practices within business environment made the stakeholders to call for risk management, governance as well as increase in the scrutiny and quality in auditing and assurance. Following the WorldCom and Euron's fraud scandals that eroded the confidence of investors in the United States, the government focuses on the impact of external auditing practice on the quality of financial reporting. In 2001, Euron Corporation filed for bankruptcy with $62 billion worth of assets. The downfall of Euron made thousands of employees to lose their jobs making thousands of shareholders to lose their money. In 2002, WorldCom also filed for bankruptcy with $100 billion worth asset making Euron case appear small in comparison. High profile scandals that swept across the United States between 2001 and 2002 have shown that quality-auditing practice is very critical for the quality accounting and financial reporting.

1 Describe the auditing profession, the regulatory, legal and reporting framework of auditing. Recognize the basic principles, objectives and ethical requirements of audit and assurance services. Identify the audit process from client acceptance, design of audit procedures and express an appropriate audit conclusion based on the audit evidence obtained.