Determination of Sample Size for Auditing Medical Insurance Claims
Published: 2012
Author(s) Name: Paritosh Chandra Sinha, Santanu Kumar Ghosh |
Author(s) Affiliation: The University of Burdwan, West Bengal, India.(*Research Scholar, **Professor)
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Abstract
In the case of sample audit of the medical insurance claims, a complex as well as serious problem arises with
the reality of the population characteristics of population error. The present study examines whether sample claims (those the
auditors consider by nature or classification) is random or not. The paper puts forward that the sample size varies with respect to
identification of different stages of audit by the Trainee, Processor, and Sr. Processor. For the first place that is, a sample audit by
the Trainee, a firm’s dependence on sample audit procedure should be taken into an utmost care. The study determines sample
size econometrically through the application of the concept in Poisson distribution. Apart from these, the study suggests some
ad-hoc population ranges and sample size against these ranges.
Keywords: Sample Audit, Sample Size, Population Error, and Medical Insurance Claims
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