QUESTION: 129

A medical insurance provider uses an electronic claims-submission process and suspects that a number of physicians have submitted claims for treatments that were not performed. Which of the following control procedures would be most effective to detect this type of fraud?

Require the physician to submit a signed statement attesting that the treatments had been performed.
Send confirmations to the physicians, requesting them to verify the exact nature of the claims submitted to the insurance provider.
Develop an integrated test facility and submit false claims to verify that the system is detecting such claims on a consistent basis.
Use computer software to identify abnormal claims based on the insured's age and medical history.

Answer(s): D

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QUESTION: 130

Which of the following is not an objective of internal control?

Compliance.
Accuracy.
Efficiency.
Validation.

Answer(s): D

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QUESTION: 131

According to the COSO enterprise risk management (ERM) framework, which of the following is not part of the new paradigm in ERM?

Assessing the risk factors.
Aligning risk appetite and strategy.
Enhancing risk response decisions.
Reducing operational surprises and losses.

Answer(s): A

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QUESTION: 132

Forty-five percent of an organization's customer payments are submitted online. Eight percent of online payments are rejected. Executive management decides to outsource its online payment services to a contractor that will assume 75 percent of the total value of rejected payments. The organization estimates$1.25 million customer payments due during the contract period.

Which of the following represents the organization's residual risk for online customer payments due?

$11, 250
$25, 000
$33, 750
$45, 000

Answer(s): A

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QUESTION: 129

QUESTION: 130

QUESTION: 131

QUESTION: 132