Evidence record
UnitedHealthcare Dental’s Financial Statistical Reports
- Jurisdiction
- Texas
- Publication date
- January 23, 2025
- Source record
- Original document linked
Findings
3
Recommendations
4
Overall conclusion
UnitedHealthcare Dental had a process for preparing and reviewing FSRs; however, internal controls were not always effective and allowed for reporting errors, which resulted in overstating reported expenses by $799,351.
Scope
The audit scope covered administrative, quality improvement, and pre-implementation expenses during the period from October 29, 2019, through August 31, 2022.
Findings (3)
Each finding has a stable link.
- F-1158
Overstated reported expenses by $799,351 on UnitedHealthcare Dental’s 2021 and 2022 FSRs and pre-implementation expense report due to internal control weaknesses and errors across nine categories.
- F-1159
Did not establish fair market value for affiliate expenses totaling $9,717 reported on 2021 FSR and pre-implementation expense report.
- F-1160
Incorrectly categorized $9,002,010 in expenses across 2021 and 2022 FSRs, with misclassification across line items such as marketing and other administrative expenses; resulting in misstatement of expenses.
Recommendations (4)
- R-1030
Strengthen FSR preparation and review procedures to ensure expenses are accurate, allowable, complete, and reported in the correct period and comply with reporting requirements.
Related finding F-1158 - R-1031
Implement a process to report affiliate expenses at the affiliate’s actual cost or establish fair market value for those expenses.
Related finding F-1159 - R-1032
Communicate with FRAC to determine the impact of not establishing fair market value for identified affiliates.
Related finding F-1159 - R-1033
Implement a process to report expenses on FSRs based on the type of expense (expense categorization by type).
Related finding F-1160