The most important weaknesses in the financial systems of medical activities based on the experiences of the external auditor

It is known that the fundamentals of the accounting profession do not differ by changing the nature of the entity's activity – as the accounting and documentary cycle is almost constant in all activities, while the differences arise from the addition of new sub-stages of the accounting and documentary cycle in order to increase internal control procedures in the financial department and the subsequent influential departments in the financial movement, in addition to providing useful financial reports to the company's leadership and help in making decisions at the right time and at the right cost .

Due to the fact that these additional procedures, as mentioned above, affect the internal control environment and procedures, they are considered one of the most important factors affecting the quality of the external auditor's work and the degree of his confidence in the correctness of reports and financial statements , because the external audit work is divided into two complementary parts, namely :

* Review of internal control systems

* Collecting sufficient evidence to express an opinion on the financial statements

And through our previous experience in the external audit of many different activities – the most important and most complex of which are medical activities in centers and hospitals, which is one of the large and complex activities in some of them due to the need to control the elements of operating costs, which are considered to be of great diversity and high value in many of them to reduce waste and waste in order to achieve the equation of the best medical service at the lowest possible cost, which will reflect on the profitability of the activity and therefore the ability to continue to compete in this competitive sector and preserve the rights of partners and shareholders . ..Which means the need to activate control systems and financial systems to control the cost of fraud.

We will review in the following points the most important weaknesses in controlling the cost of such activities, which require the activation of governance systems to prevent the occurrence of any errors, manipulation, cheating, waste and extravagance in operating requirements

One of the most important weaknesses that the external auditor faces in such activities is :

1. The absence of a system to control the prices of medical procedures through fixed price lists, especially with regard to contracts from unions, bodies and private contracts .

2. The need to have a system to control the prices of external doctors ' packages that would control the cost of the package and preserve the hospital's rights in the medical procedures performed .

3. The absence of a control system on the discharge from the stores for surgical operations on weekdays would control the type and quantity of supplies discharged and the nature and type of medical procedures in addition to the inventory of surplus supplies and consumables in the operating rooms to resupply them to the stores .

4. The need to have an approved and electronic system for the cost of anesthesiologists and external doctors – each according to his contract with the hospital – and avoid human intervention in calculating these dues .

5. The presence of control systems on the limit of re – ordering in stores is responsible for alerting about items and supplies that are about to run out to re-order-especially since the nature of the activity does not tolerate a shortage of these supplies, especially in emergency situations.

6. The existence of salary control systems, especially overtime hours, due to the fact that the nature of the activity may be 24 hours a day, all days of the week, which requires multi-tasking and specialized human resources that need an administrative and accounting system to control the cost of wages and salaries due to the dependence of the activity primarily on the human element in performing the service to the client .

7. The presence of a control system responsible for issuing the patient's bill correctly, including the services provided to the patient and the number and type of medical consumables that were used without any dispute from reality .

8. The presence of a control system to follow up the occupancy of rooms and residences properly and orderly

In the past, these control systems were activated through paper-based documentary courses that consumed time in following up their application ... While at the present time, accounting programs ER P are the ones who follow up the application of control systems in an electronic form that keeps pace with the requirements for the speed of extracting reports through which decisions are made that are in favor of the establishment .