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