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Industry-Specialized Auditors

Healthcare Audit Services in Dubai & UAE

Hospitals | Clinics | Medical Centers | DHA/DOH Compliance

Specialized audit services for healthcare providers including hospitals, medical centers, clinics, diagnostic centers, and pharmaceutical companies. Our healthcare audit experts understand DHA/DOH regulations, insurance claim verification, medical inventory controls, and patient data confidentiality.

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Industry Specialists
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Healthcare Sector in the UAE

The UAE healthcare sector has grown exponentially, with Dubai Health Authority (DHA) and Department of Health (DOH) Abu Dhabi overseeing a sophisticated ecosystem of public and private hospitals, specialty clinics, diagnostic centers, and pharmaceutical distributors. The sector is valued at over $20 billion with strict regulatory oversight covering clinical quality, patient safety, pricing controls, and insurance reimbursement. All healthcare entities require annual audits under UAE Commercial Companies Law, with additional regulatory audits often required by DHA or insurance networks.

Healthcare audits require specialized knowledge: revenue recognition from insurance claims and patient services, medical inventory controls for pharmaceuticals and consumables, patient data confidentiality per UAE data protection laws, employment cost accounting for clinical staff, capitalization of medical equipment, and compliance with health authority pricing regulations. Our healthcare audit team has examined over 80 healthcare providers across specialties including general hospitals, dental clinics, IVF centers, diagnostic labs, and pharmacy chains.

Recent regulatory changes including mandatory health insurance coverage, DHA pricing transparency initiatives, and enhanced quality accreditation requirements (JCI, CBAHI) mean healthcare providers face increasing compliance complexity. Our integrated approach covers financial reporting, operational controls, patient data security, insurance claim accuracy, and regulatory compliance in a comprehensive audit engagement.

Unique Challenges in Healthcare Audits

Industry-specific audit complexities that require specialized expertise and proven methodologies

Insurance Claim Revenue Recognition
Healthcare revenue from insurance requires complex accounting: claims submitted to insurers must be recognized at estimated collectible amounts, with allowances for claim rejections, pre-authorization issues, and negotiated rate differences. Auditors must verify claim aging, rejection rates, and collectibility estimates.
Medical Inventory Controls
Pharmaceuticals, medical supplies, and consumables require stringent controls including temperature monitoring, expiry date tracking, batch recall procedures, and restricted access. Auditors must verify physical security, perpetual inventory accuracy, and obsolescence provisions.
Patient Data Confidentiality
Healthcare providers process sensitive patient health data subject to UAE data protection laws and DHA privacy regulations. Auditors must assess IT controls, access restrictions, data encryption, and breach notification procedures without accessing actual patient information.
DHA/DOH Regulatory Compliance
Healthcare facilities must comply with health authority regulations covering pricing transparency, clinical protocols, accreditation standards, practitioner licensing, and facility standards. Auditors verify compliance with applicable requirements and proper documentation.
Medical Equipment Capitalization
Sophisticated medical equipment (MRI, CT scanners, surgical robots, etc.) involves significant capital investment requiring proper capitalization, useful life assessment, and residual value estimates. Auditors must understand equipment functionality to assess accounting treatment.
Employment Cost Allocation
Clinical staff costs (doctors, nurses, technicians) must be allocated between patient care (capitalized to revenue-generating activities) and non-billable time. Auditors verify timekeeping systems and cost allocation methodologies.

Healthcare Regulatory Framework

Comprehensive compliance coverage across all applicable regulations and standards

DHA (Dubai Health Authority)
Primary health regulator for Dubai emirate
  • Healthcare facility licensing and renewal
  • Practitioner licensing verification
  • Pricing transparency compliance (Sheryan portal)
  • Clinical quality standards and protocols
  • Patient rights and complaint handling
  • Infection control and patient safety protocols
DOH (Department of Health - Abu Dhabi)
Health regulator for Abu Dhabi emirate
  • Facility and practitioner licensing
  • SEHA standards compliance (for public sector)
  • Quality accreditation (CBAHI, JCI)
  • Healthcare pricing regulations
  • Patient safety and adverse event reporting
Insurance Regulations
DHA mandatory health insurance and insurer requirements
  • Network provider agreements compliance
  • Pre-authorization procedures
  • Claim submission and documentation
  • Pricing per insurance schedule rates
  • Medical necessity justification
UAE Data Protection Law
Federal Decree-Law No. 45 of 2021 on Personal Data Protection
  • Patient health data classification as sensitive data
  • Consent requirements for data processing
  • Data security and encryption measures
  • Breach notification within 72 hours
  • Data retention and disposal policies

Our Healthcare Audit Methodology

We apply specialized procedures designed for healthcare operations, balancing financial audit rigor with patient confidentiality and operational sensitivity.

1

Planning & Risk Assessment

We conduct comprehensive understanding of your healthcare delivery model, revenue streams, regulatory environment, and critical controls.

Key Deliverables:

  • Healthcare business model analysis
  • Revenue cycle assessment (patient registration to collection)
  • Medical inventory and pharmacy controls evaluation
  • IT controls for patient data systems
  • Regulatory compliance requirements mapping
  • Insurance claim process review
2

Fieldwork & Substantive Testing

Our team performs targeted testing of high-risk areas including revenue recognition, insurance claims, medical inventory, and compliance documentation.

Key Deliverables:

  • Insurance claim testing (submission to collection)
  • Patient revenue recognition and allowance review
  • Medical inventory physical count and controls testing
  • Medical equipment additions and depreciation verification
  • Payroll and clinical staff cost allocation testing
  • Patient data access controls review
3

Reporting & Compliance Advisory

We provide audit opinions plus strategic guidance on revenue cycle optimization, compliance improvements, and operational efficiency.

Key Deliverables:

  • Audited financial statements (Arabic & English)
  • Independent auditor's report per ISA standards
  • Management letter with recommendations
  • Revenue cycle optimization opportunities
  • Regulatory compliance improvement roadmap
  • Insurance claim denial reduction strategies

Why Choose Our Healthcare Audit Services

Healthcare Sector Expertise

Our team includes auditors with specialized healthcare experience who understand medical terminology, clinical operations, insurance reimbursement mechanics, and DHA/DOH regulatory environment.

Revenue Cycle Specialists

We have dedicated revenue cycle specialists who can analyze your entire patient journey from registration through claim submission, adjudication, and collection, identifying revenue leakage and denial reduction opportunities.

Patient Data Confidentiality

All our auditors are trained on healthcare data confidentiality and sign HIPAA-equivalent NDAs. We have procedures to test patient data controls without accessing actual patient health information, protecting privacy.

JCI/CBAHI Understanding

Our team includes auditors familiar with Joint Commission International (JCI) and CBAHI accreditation standards, allowing us to align financial audit with quality accreditation requirements where applicable.

Insurance Expertise

We understand all major UAE health insurance providers (Daman, Cigna, AXA, Oman, Saico, etc.) and their claims processing requirements, helping you optimize claim acceptance rates and reduce denials.

Pharmacy & Lab Experience

We have audited standalone pharmacies, diagnostic laboratories, and medical centers with in-house pharmacy and lab operations, understanding the unique inventory and revenue recognition challenges.

Common Audit Findings in Healthcare

Learn from common issues we identify and how to resolve them proactively

Issue

Insurance Claim Receivable Overstatement

Impact

Claims submitted to insurers recognized as revenue without adequate allowance for denials, resulting in receivables overstatement

Solution

Analyze historical claim denial rates by insurer and service type, establish appropriate allowance, write off aged uncollectible claims

Issue

Medical Inventory Expiry Not Monitored

Impact

Expired pharmaceuticals and medical supplies not identified and written off, overstating inventory value

Solution

Implement FEFO (First-Expiry-First-Out) system, conduct monthly expiry checks, establish write-off policy for near-expiry items

Issue

Revenue Recognition Before Service Delivery

Impact

Patient deposits or insurance pre-authorizations recognized as revenue before actual medical service provided

Solution

Record advance payments as deferred revenue (liability), recognize revenue only upon service delivery

Issue

Patient Data Access Controls Weak

Impact

Inadequate restrictions on who can access patient health records, violating UAE data protection laws

Solution

Implement role-based access controls, audit trails for patient data access, annual access rights review

Issue

Medical Equipment Depreciation Inappropriate

Impact

Medical equipment depreciated over incorrect useful life, misstating asset values and depreciation expense

Solution

Assess useful life based on equipment type and usage intensity, align with manufacturer specifications and clinical standards

Issue

DHA Pricing Violations

Impact

Services billed at rates exceeding DHA-approved pricing schedules (Sheryan portal), risking regulatory penalties

Solution

Reconcile service pricing to DHA-approved rates, implement automated pricing validation in billing system

Contact us for Healthcare Audit Service

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Success Story

Case Study: Multi-Specialty Medical Center Revenue Cycle

The Challenge

A 50-bed medical center with 12 specialties faced cash flow issues due to high insurance claim denial rates (25%) and long collection cycles (120+ days). Their accounts receivable was growing faster than revenue, and they lacked visibility into denial reasons. Previous audits highlighted weak revenue controls.

Our Solution

We conducted comprehensive revenue cycle analysis from patient registration through final collection. We identified root causes: incomplete pre-authorization verification, coding errors, missing documentation, and lack of denial follow-up. We recommended EMR system enhancements, staff training on documentation, and dedicated denial management team.

Measurable Results

Insurance claim denial rate reduced from 25% to 8%
Days in receivables improved from 120 to 75 days
Revenue increased 12% through better claim acceptance
Implemented automated pre-authorization checking
Recovered AED 800K in previously denied claims through appeals

Frequently Asked Questions

Get answers to common questions about our industry-specialized audit services

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