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Recovery auditing is the systematic process of reviewing disbursement transactions and the related supporting data to identify and recover various forms of over payments and under-deductions to suppliers. In other words, it is the recovery of lost money.
Recovery auditing was at first primarily for retail based companies. It was developed in the 1970s as a result of companies losing millions of dollars annually because of unpaid invoices, duplicate payments, discounts and allowances not received and general overpayments. Before recovery auditing, this "lost money" was too difficult to identify due to the large amount of transactions processed every year. Companies began investigating deeper into their accounting and found errors in their favor. T
In the United States, two of the largest contributions made by this industry was the Improper Payments Act of 2002 (IPIA) spearheaded by Paul Dinkins and the Medicare Modernization Act of 2003.
An audit is an "independent examination of financial information of any entity, whether profit oriented or not, irrespective of its size or legal form when such an examination is conducted with a view to express an opinion thereon.” Auditing also attempts to ensure that the books of accounts are properly maintained by the concern as required by law. Auditors consider the propositions before them, obtain evidence, and evaluate the propositions in their auditing report.
The Bank Secrecy Act of 1970 (BSA), also known as the Currency and Foreign Transactions Reporting Act, is a U.S. law requiring financial institutions in the United States to assist U.S. government agencies in detecting and preventing money laundering. Specifically, the act requires financial institutions to keep records of cash purchases of negotiable instruments, file reports if the daily aggregate exceeds $10,000, and report suspicious activity that may signify money laundering, tax evasion, or other criminal activities.
The Medicare Prescription Drug, Improvement, and Modernization Act, also called the Medicare Modernization Act or MMA, is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare in the public health program's 38-year history.
The Health Insurance Portability and Accountability Act of 1996 is a United States federal statute enacted by the 104th United States Congress and signed into law by President Bill Clinton on August 21, 1996. It was created primarily to modernize the flow of healthcare information, stipulate how personally identifiable information maintained by the healthcare and healthcare insurance industries should be protected from fraud and theft, and address limitations on healthcare insurance coverage.
Accounts payable (AP) is money owed by a business to its suppliers shown as a liability on a company's balance sheet. It is distinct from notes payable liabilities, which are debts created by formal legal instrument documents.
In business and accounting, information technology controls are specific activities performed by persons or systems designed to ensure that business objectives are met. They are a subset of an enterprise's internal control. IT control objectives relate to the confidentiality, integrity, and availability of data and the overall management of the IT function of the business enterprise. IT controls are often described in two categories: IT general controls (ITGC) and IT application controls. ITGC include controls over the Information Technology (IT) environment, computer operations, access to programs and data, program development and program changes. IT application controls refer to transaction processing controls, sometimes called "input-processing-output" controls. Information technology controls have been given increased prominence in corporations listed in the United States by the Sarbanes-Oxley Act. The COBIT Framework is a widely used framework promulgated by the IT Governance Institute, which defines a variety of ITGC and application control objectives and recommended evaluation approaches. IT departments in organizations are often led by a chief information officer (CIO), who is responsible for ensuring effective information technology controls are utilized.
The know your customer or know your client (KYC) guidelines in financial services require that professionals make an effort to verify the identity, suitability, and risks involved with maintaining a business relationship. The procedures fit within the broader scope of a bank's Anti-Money Laundering (AML) policy. KYC processes are also employed by companies of all sizes for the purpose of ensuring their proposed customers, agents, consultants, or distributors are anti-bribery compliant, and are actually who they claim to be. Banks, insurers, export creditors, and other financial institutions are increasingly demanding that customers provide detailed due diligence information. Initially, these regulations were imposed only on the financial institutions but now the non-financial industry, fintech, virtual assets dealers, and even non-profit organizations are liable to oblige.
The Bureau of the Public Debt was an agency within the Fiscal Service of the United States Department of the Treasury. United States Secretary of the Treasury Timothy Geithner directed the Bureau be combined with the Financial Management Service into the single Bureau of the Fiscal Service in 2012.
A chargeback is a return of money to a payer of some transaction, especially a credit card transaction.
Internal control, as defined by accounting and auditing, is a process for assuring of an organization's objectives in operational effectiveness and efficiency, reliable financial reporting, and compliance with laws, regulations and policies. A broad concept, internal control involves everything that controls risks to an organization.
Continuous monitoring is the process and technology used to detect compliance and risk issues associated with an organization's financial and operational environment. The financial and operational environment consists of people, processes, and systems working together to support efficient and effective operations. Controls are put in place to address risks within these components. Through continuous monitoring of the operations and controls, weak or poorly designed or implemented controls can be corrected or replaced – thus enhancing the organization's operational risk profile. Investors, governments, the public and other stakeholders continue to increase their demands for more effective corporate governance and business transparency.
Oversight Systems is a U.S.-based company, founded in 2003, which develops and sells computer software that helps businesses continually check for employee and vendor fraud, misuse and errors with expense reporting, purchasing cards and billing. The software also helps public companies with the monitoring and testing of controls associated with Sarbanes-Oxley Act and the Foreign Corrupt Practices Act (FCPA) compliance. Oversight's claimed target customers are companies taking in US$600 million or more in yearly revenue.
The Recovery Audit Contractor, or RAC, program was created through the Medicare Modernization Act of 2003 (MMA) to identify and recover improper Medicare payments paid to healthcare providers under fee-for-service (FFS) Medicare plans. The United States Department of Health and Human Services (DHHS) is required by law to make the program permanent for all states by January 1, 2010 under section 302 of the Tax Relief and Health Care Act of 2006.
In the tax law of the United Kingdom, tax credit overpayment occurs when a claimant has received more Working Tax Credit (WTC) or Child Tax Credit (CTC) than HMRC’s final end of year calculations awards them. This can be caused by official or claimant error or neglect, or simply because the provisional payments were based on out of date information. This article is solely about overpayment, not about details of the tax system as a whole.
Council for Affordable Quality Healthcare, Inc. is a non-profit organization incorporated in California as a mutual benefit corporation. It was first incorporated under the name Coalition for Affordable, Quality Healthcare, Inc., and then was renamed the Council for Affordable Quality Healthcare, Inc. on August 8, 2002. It is based in Washington, D.C.. Previously a 501(c)6 tax-exempt organization, CAQH changed its tax status in 2016, although it remains a non-profit.
An error account is a type of account used for storing compensation for errors in trading, a transaction that is not posted in a timely manner because of inconsistencies, such as an incorrect account or routing numbers to the wrong name on the account, producing a claim that needs to be resolved as soon as possible so payments can be made.
Entry visibility is an aspect of supply chain visibility, allowing a company to manage the proper use of trade compliance data for the importation of goods from the time they leave a foreign supplier until the time those goods reach their destination. Entry visibility aims to ensure that all regulatory, compliance, and documentation requirements are met in a timely fashion along the way. When importing into the U.S., every individual transaction must be compliant with The Customs Modernization Act, and the Importer Security Filing (10+2). Under the Mod Act, importers are required to maintain and produce timely records at the time of entry. Furthermore, the Mod Act includes a "Reasonable Care" clause, which states that importers and brokers need a comprehensive audit process to ensure they have met all compliance requirements and provided the correct information on all entry filings.
Parcel audit is the process of reviewing shipping invoices for invalid charges and other billing inaccuracies. Each shipment tendered to a major parcel carrier like UPS and FedEx come with service guarantees outlined within each carrier's tariff or service guide. An increasing number of businesses contract third-party companies to perform these services because they have the technology necessary to automate the otherwise time-consuming process.
Connolly, LLC is a private, global-recovery audit firm with more than 1,200 employees, and two divisions Global Retail and Healthcare. The company is headquartered in Wilton, Connecticut. Recovery auditing is a financial best practice recognized by leading organizations worldwide for reducing clients' erroneous payments, improving their processes, and enhancing their performance. Connolly’s clients include many of the world’s largest and best run companies in virtually all industries.
The 340B Drug Pricing Program is a US federal government program created in 1992 that requires drug manufacturers to provide outpatient drugs to eligible health care organizations and covered entities at significantly reduced prices. The intent of the program is to allow covered entities to "[s]tretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services." Maintaining services and lowering medication costs for patients is consistent with the purpose of the program, which is named for the section authorizing it in the Public Health Service Act (PHSA) It was enacted by Congress as part of a larger bill signed into law by President George H. W. Bush.