Search

Although health care providers have more than 47 million health insurance clients in Brazil, these companies still have processes that are manual. One of these processes is that of the medical audit that performs the analysis of each account with expenses that were incurred by the operator's beneficiary in any hospital, clinic or laboratory. Each account is reviewed to make sure that there is nothing outside the context of a surgery, examination or consultation. The costs of these audits are high and the outcome is varied and according to the auditor's individual knowledge. In addition to being a lengthy process, these bills will only be paid to those who provided the service after the auditors' review which brings dissatisfaction to those awaiting payment. Manual execution of this process is susceptible to failure and fraud. In this context, Machine Learning algorithms are used to assist in the audit process in various areas of knowledge. Thus, this paper presents a survey on the application of Machine Learning algorithms in medical audits, analyzing which algorithms are most used. [ABSTRACT FROM AUTHOR]

The audit is an independent source of information, covering all the processes that make up a quality assurance system In this sense,this study had as main objective to analyze the scientific production on audit in the supplemental health and by specific objectives to identify the main themes present in the scientific production and to discuss possible approximations and distances in the researches that were the object of the analysis. It is an integrative review of the literature that adopted the thematic content analysis technique. The paper analyzed the studies in the Brazilian Digital Library of Theses and Dissertations (BDTD), in the Latin American and Caribbean Literature database in Health Sciences - LILACS and in the virtual library Scientific Electronic Library Online - SciELO. Fourteen studies were identified and the themes that emerged from the analysis of these studies were: health quality improvement and cost reduction. It was concluded that while some studies have underscored that the improvement of health quality and cost reduction may be considered as complementary actions, other productions have revealed tension and even antagonistic relations that emerge between these elements. [ABSTRACT FROM AUTHOR]

This paper aimed to evaluate whether the audit report issued with modified opinion impacts the agreement between auditor and client. In addition, it was found whether the fact that once the audit firm is a big four or the audited company adopts corporate governance practices can reduce the risk of discontinuation of the contractual relationship, even with the issue of modified opinion. The empirical tests revealed that: in the brazilian capital market, there is a positive and statistically significant relationship between the modified opinion and the auditors' changing in the following period; and the fact of an audit firm being a big four or the company adopts corporate governance practices do not reduce the risk of discontinuity between the parts. The results demonstrate a worrying picture concerning auditors' independency when they issued a report with modified opinion. [ABSTRACT FROM AUTHOR]

This paper describes the audit process carried out on 26 digital repositories according to the recently established standard ISO16363 - Audit and Certification of Trustworthy Digital Repositories. The 26 repositories are currently hosted at RCAAP (Open Access Scientific Repository from Portugal), a free hosting service provided to research institutions in Portugal. This work presents the first results of the analysis of the three topics: Organizational Infrastructure; Digital Object Management; and Infrastructure and Security Risk Management. It addresses the process and the strategic alignment with the project objectives integrated with other developments related to digital preservation of institutional repositories. [ABSTRACT FROM AUTHOR]

The main goal of this paper is to analyze if, in a small capital market such as the Portuguese, the audit expectation gap exits and which are its major components. We have enquired auditors and University accounting and auditing professors regarding several subjects that influence and increase the audit expectation gap. We have also questioned the Portuguese users of financial information regarding their perception of the role of today's auditing, to assay their opinion with studies made in Anglo-Saxon countries. We have reached the conclusion that Portuguese financial statements users' expectations are similar to the ones of bigger capital markets. As a matter of fact, fraud is the main cause for the existence of the audit expectation gap, nevertheless, Portuguese financial statements users also indicate that the actual auditor's report model in Portugal is clearly insufficient to comprehend the objectives and work that auditors have done to reach their conclusions. [ABSTRACT FROM AUTHOR]