“ACL software is a wonderful tool to help auditors gain greater data coverage in an efficient and effective way. Bon Secours a big proponent of ACL, and we feel it’s valuable in every audit we do.”
Bryon Neaman, Director of Internal Audit, Bon Secours Health System, Inc.
Bon Secours is among the largest US Catholic healthcare providers with hospitals and care facilities in nine states. The internal audit department faces significant data analysis challenges, given the size and complexity of vendor files, and human resources data. The audit team must also respond to ever-changing healthcare legislation from local, state, and federal governments. Bon Secours chose market-leading ACL technology to implement a continuous monitoring strategy and gain increased coverage of company data. In only three months, internal auditors identified over £305,000 in duplicate payments, and in an 18-month period, found over £610,000 in lost gross patient charges. Committed to constantly improving controls certification within the organisation, Bon Secours relies on ACL to meet – and exceed – its internal controls requirements.
Bon Secours Health System, headquartered in Marriottsville, Maryland, owns, manages, or jointly operates 24 acute-care hospitals, one psychiatric hospital, nine nursing care facilities, eight assisted living facilities, two retirement communities, home healthcare services, and hospices. It is a £1.4 billion not-for-profit Catholic health system (FY 2002 total revenues). Bon Secours’ more than 27,000 caregivers serve people in 15 communities in nine states, primarily on the East Coast. The Congregation of Sisters of Bon Secours also has healthcare ministries in France, Ireland, Great Britain, and Peru.
With more than 40 healthcare facilities across the United States, Bon Secours auditors must quickly adapt to legislative changes at the local, state, and federal levels. These regulatory shifts can influence reporting procedures, billing practices, and insurance payments, among other day-to-day procedures.
Due to the enormous data volumes flowing through its facilities, Bon Secours needed a powerful and effective data analysis solution that could accommodate staff with less technical backgrounds. The audit team also needed a way to handle large data files. For example, just one patient accounting office will manage over 100,000 active accounts, plus additional data generated by daily billing procedures.
Accessing data was another challenge for internal auditors. In order to generate reports and summaries, staff needed to follow a time-consuming extraction procedure, which could take up to 30 minutes per file.
Finally, Bon Secours was looking for a more effective way to assess the quality of its internal controls and business processes, and test the integrity, accuracy, and reliability of company data. With large file volumes in multiple locations, the internal audit team was only able to sample data, and was missing potential opportunities for performance enhancement and cost savings.
The Bon Secours audit team quickly embraced ACL for its adaptability, especially in light of shifting healthcare regulations. “ACL is an essential and highly flexible tool in our audit toolkit,” says Bryon Neaman, director of internal audit. “With ACL technology, we’re better equipped to deal with changing regulations and a constantly evolving industry.”
Recently, the internal audit team began a continuous monitoring initiative focused on accounts payable files. In only three months, the audit team uncovered £305,000 in duplicate vendor payments. Bon Secours auditors also used ACL technology to analyse coding procedures on medical service bills, and found over £610,000 in lost gross patient charges during an 18-month time frame. These quick and dramatic findings not only improved the organisation’s bottom line, but also raised the profile of the internal audit team throughout the organisation. “Our initial findings generated considerable interest,” says Neaman. “These are big dollars, and everyone wanted to know how we found them. I think ACL will soon be more than an internal audit tool – it will be an organisational tool.”
ACL solutions have also enabled Bon Secours auditors to improve their reach and efficiency. Complex data transfers are now streamlined to allow downloading, analysis, and report generation with just one user application. With ACL, internal audit has automated data handling processes that used to require manual intervention – allowing staff to spend valuable time exploring anomalies, and improving quality assurance and controls compliance procedures.
Bon Secours auditors are continually expanding their utilisation of ACL. For example, auditors will periodically use ACL to validate the accuracy of Bon Secour employee health coverage elections and related premiums. “This exercise provides assurance to our management team that our employees have health coverage consistent with their requests, and that the related insurance premiums assessed by our third-party administrator are accurate,” says Neaman.
The Bon Secours audit team has used ACL technology to: