The review began with the interview of board members, managers, and other key employees. This information provided insight into the health care company's procedures and allowed Miller Grossbard to flow chart the process from the initiation of a purchase order through to the signing of the payment. Afterwards, a compliance check was performed to verify that actual practice conformed to management's approved procedures. This exercise highlighted certain issues related to internal controls, the segregation of duties, and training.

The health care company acknowledged that although its accounting staff was highly organized, it was small. This had resulted in a compromise of the proper segregation of duties as well as certain internal controls. In addition, the board members who signed checks were unaware of the proper safeguards for handling support documentation.

Miller Grossbard & Associates recommended procedural enhancements to the system, document changes to strengthen internal controls, and the formalization of board member training.

The client accepted all of the recommendations and implemented the changes.