EXHIBIT 02 // CORE INTEGRITY ARCHITECTURE
01. THE REGULATORY LANDSCAPE
The healthcare sector remains one of the most complex financial environments, characterised by high-volume transactions and fragmented administrative oversight. This complexity often masks systemic billing irregularities, procurement fraud, and the subtle "leakage" of institutional funds.
Whether navigating the pressures of medical aid audits or investigating internal financial misconduct, the stakes are not merely financial - they are reputational. We provide the clinical oversight necessary to identify vulnerabilities in your revenue cycle and ensure that your institution meets the highest standards of financial governance and ethical administration.
02. OUR METHODOLOGY
We utilise specialised forensic accounting techniques tailored specifically for the medical-legal landscape. Our approach ensures that every transaction is verified and every anomaly is accounted for:
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Revenue Cycle Integrity Audit: A granular review of billing patterns to identify over-billing, "upcoding," or duplicate claims that trigger regulatory red flags.
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Payroll & Employee Verification: Utilising data-matching algorithms to detect ghost employees, unauthorised overtime payments, and "kickback" schemes within medical staffing.
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Procurement Forensic Analysis: Investigating vendor relationships and supply chain pricing to uncover undisclosed interests or inflated pharmaceutical/equipment costs.
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Damage Quantification: Providing precise, expert-backed calculations of financial losses for use in civil recovery or criminal prosecution.
03. TECHNICAL SPECIALISATIONS
Our specialised forensic accounting services include:
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Fraud Investigations
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Pharmaceutical & Other Supply Chain Forensics
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Ghost Employee Identification & Payroll Fraud
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Third-Party Administrator (TPA) Oversight
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Billing & Claims Integrity Investigations
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Healthcare Internal Control Environment (ICE) Testing
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Managed Care Organisation (MCO) Compliance
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Asset Tracing & Financial Recovery
ALL INQUIRIES ARE HANDLED WITH STRICT FORENSIC CONFIDENTIALITY