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EXHIBIT 4-1

CHAPTER 4

BILLING SCHEMES

LEARNING OBJECTIVES

After studying this chapter, you should be able to:

4-1 List the five major categories of fraudulent disbursements
4-2 Define billing schemes
4-3 List the three categories of billing schemes
4-4 Understand what a shell company is and how it is formed
4-5 List and understand the four ways false invoices are approved for payment
4-6 Understand why most shell company schemes involve the purchase of services rather than goods
4-7 Understand how a pass-through scheme differs from the usual shell company schemes
4-8 Be familiar with the methods identified in this chapter for preventing and detecting shell company schemes
4-9 Understand how pay-and-return schemes work
4-10 Understand how nonaccomplice vendor schemes work
4-11 Be familiar with the methods identified in this chapter for preventing and detecting nonaccomplice vendor schemes
4-12 Understand how personal purchases schemes work
4-13 Be familiar with the methods identified in this chapter for preventing and detecting personal purchases schemes
4-14 Be familiar with proactive audit tests that can be used to detect billing schemes

CASE STUDY: MEDICAL SCHOOL TREATS FRAUD AND ABUSE1

Fraud seemed to plague a certain Southeastern medical college, with one bad case erupting after another. One supervisor's minor transgression opened a Pandora's ...

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