Page 1 of 4 ACC30003 Forensic Accounting S2, 2016 Assignment (to be done IN PAIRS) Part A - Case Study: You are a graduate accountant and have just landed your dream job with a forensic accounting firm in Hawthorn, Victoria. Your boss has asked you to travel to their US office to work with the team on a potential dental insurance fraud case, and gain valuable experience in investigative techniques. The company you are assisting processes dental insurance claims for insurance companies. The company receives the insurance claims from dental offices, achieves authorisation from the correct insurance company, and sends payment cheques. In your role you work with the insurance companies and dental offices - you do not deal with dental customers directly. After two months with the company, you think a number of frauds may be occurring, and you feel the best way to search for these frauds is to investigate documentary evidence. Because hundreds of dental offices send insurance claims to your office, some may not be real dental offices. You contact the IT department and receive a set of files that represent the documents involved in transactions for the past three months: Download the following files from Blackboard:  Claims.csv  Dentists.csv  Patients.csvPage 2 of 4 Questions: 1. As a forensic accountant, the first thing you should do with these files is calculate a checksum. a. Explain thoroughly what a checksum is, and why this is the first thing you should do with these files. b. Using the following online checksum calculator https://defuse.ca/checksums.htm#checksums calculate the SHA-1 checksum for the following files: i. Claims.csv ii. Dentists.csv iii. Patients.csv c. Why might your checksums be different from other students in this class? d. Explain what each of the files represents – what information is contained within. 2. Some dental offices may not employ real dentists and may be front companies that are sending claims out for work not performed. Are there any dental offices that you suspect may not be real? What makes you suspect this? 3. Sort the claims file by columns C & B. Are there any suspicious entries? Why? 4. Using the claims file, ascertain if any patients seem to be visiting their dentist too often? Which dentist and patients makes you most suspicious and explain why you are suspicious? 5. Are there any anomalies in patient addresses that make you suspicious of fraudulent activity? Part B – Essay (1,000 words): Insurance providers beware: There are many ways to perpetrate dental insurance fraud. Discuss. Submission:  Assignment is due Tuesday 20th September 2016 at 12.30pm (please hand to your tutor):  Ensure BOTH students' names/ids are included in a header or footer.  You are required to submit both an electronic copy of your assignment (using Turnitin) and a hardcopy of your assignment:  Unless both the electronic copy and the hardcopy are received, your assignment will not be marked and you will receive a score of zero (0).  There is only one Turnitin folder – use this to upload drafts and the final assignment.  You can upload as many draft assignments to Turnitin as you want – the version in Turnitin as at the due date will be taken as your final submission.  Only ONE student per pair is to upload the draft and final assignment to Turnitin.  No coversheet is required for the electronic submission – but you must include one with your hardcopy.Page 3 of 4 Part A: MARKING Criteria: Not Pass Pass 50-59% Credit 60-69% Distinction 70-79% High Distinction 80-100% Question 1 Not all parts are answered (0– 3) Limited consideration of parts a, c & d. Checksums calculated correctly. (4-5) Good consideration of parts a, c & d. Checksums calculated correctly. (6) Very good consideration of parts a, c & d. Checksums calculated correctly. (7) Detailed, thorough consideration of parts a, c & d. Checksums calculated correctly. (8) Question 2 Seemed confused about the question. (0) Limited explanation of rationale. Response covers some correct dental offices. (1.5) Good explanation of rationale. Response covers many correct dental offices. (2) Very good explanation of rationale. Response covers most correct dental offices. (2.5) Detailed, thorough explanation of rationale. Response covers all correct dental offices. (3) Question 3 Seemed confused about the question. (0) Limited explanation of rationale. Response covers some correct sequential claims. (1.5) Good explanation of rationale. Response covers many correct sequential claims. (2) Very good explanation of rationale. Response covers most correct sequential claims. (2.5) Detailed, thorough explanation of rationale. Response covers all correct sequential claims. (3) Question 4 Seemed confused about the question. (0) Limited explanation of rationale. Response covers calculations and some correct patients. (1.5) Good explanation of rationale. Response covers calculations and many correct patients. (2) Very good explanation of rationale. Response covers calculations and most correct patients. (2.5) Detailed, thorough explanation of rationale. Response covers calculations and all correct patients. (3) Question 5 Seemed confused about the question. (0) Limited explanation of rationale. Response covers some anomalies. (1.5) Good explanation of rationale. Response covers many anomalies. (2) Very good explanation of rationale. Response covers most anomalies. (2.5) Detailed, thorough explanation of rationale. Response covers all correct anomalies. (3)Page 4 of 4 Part B: Essay MARKING Criteria: Not Pass Pass 50-59% Credit 60-69% Distinction 70-79% High Distinction 80-100% Understanding Indicates confusion about the topic or neglects important aspects of the topic (eg. no discussion of Hicaps). (0-3) Demonstrates some understanding of the topic. Limited depth in coverage and confused discussion of Hicaps. (4-4.5) Demonstrates a generally accurate understanding of the topic (including Hicaps). (5-6) Demonstrates a sound understanding of the topic (including Hicaps). (7) Demonstrates a thorough understanding of the topic by developing an insightful response. (8) Spelling and punctuation There are more than five or more spelling or punctuation errors. (0) There are less than five spelling or punctuation errors. (1) Reference List No reference list provided OR not compliant with Harvard standard. (0) Accurate reference list that is fully compliant with the Swinburne Harvard referencing standard. (1)