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Asia Pacific Fraud Journal

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Published by Association of Certified Fraud Examiners Indonesia Chapter

ISSN : 25028731 EISSN : 2502695X DOI : -

Core Subject : Economy, Social,

Economics, Econometrics & Finance Social Sciences

ASIA PACIFIC FRAUD JOURNAL (APFJ) firstly published by Association of Certified Fraud Examiners (ACFE) Indonesia Chapter in 2016. APFJ registered on CrossRef, then every article published di APFJ has Digital Object Identifier (DOI). APFJ published research and review articles. APFJ also published the articles from Call For Paper that managed by ACFE Indonesia Chapter. - Forensic Accounting - Fraud Prevention - Fraud Detection - Investigation - Crime - Criminalogy.

Arjuna Subject : -

Articles 264 Documents

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ROOT CAUSE ANALYSIS USING FRAUD PENTAGON THEORY APPROACH (A CONCEPTUAL FRAMEWORK) Dona Ramadhan
Asia Pacific Fraud Journal Vol 5, No 1: Volume 5, No. 1st Edition (January-June 2020)
Publisher : Association of Certified Fraud Examiners Indonesia Chapter

Fraud and corruption are two types of crimes that can harm others. According to Transparency International, the perceived level ofpublic sector corruption in Indonesia was ranked 89 out of 180 countries in the world in 2018. Seeing this condition, more attention should be paid to the prevention and deterrence process to reduce the more losses. This study aims to develop a conceptual framework for fraud prevention and deterrence by developing root cause analysis using the pentagon fraud approach. Through a literature review, researcher tries to combine root cause analysis with fraud pentagon, called RCA-FP Matrix (Root Cause Analysis - Fraud Pentagon Matrix) as an effective tool to prevent and deter fraud and corruption. This study also provides an example of the application of RCA-FP Matrix. First, determining the list of root causes associated with Fraud Pentagon; second, choosing one of the causes, as the root cause of fraud findings. In this study, fraud findings are calculated based on account numbers. Finally, the frequency of all causes can be counted, and the main root causes can be found. The results using the RCA-FP matrix show that there aredifferent dominant causes in different regions. Capability is the most frequent case in company-wide. The RCA-FP matrix can be applied in all types of industries and government agencies. As an anti-fraud measure, the RCA-FP Matrix can be adjusted according to the nature of the organization.

DOES MORAL HAZARD OCCOUR IN THE IMPLEMENTATION OF SOCIAL HEALTH INSURANCE? EVIDENCE FROM PUBLIC HOSPITALS IN A RURAL PROVINCE OF INDONESIA Rizanda Machmud; Syafrawati Syafrawati; Prof. Syed Mohamed Aljunid; Rima Semiarty
Asia Pacific Fraud Journal Vol 5, No 1: Volume 5, No. 1st Edition (January-June 2020)
Publisher : Association of Certified Fraud Examiners Indonesia Chapter

Indonesia is now encountering moral hazard problems in the implementation of social health insurance. BPJS, as the administrator of Indonesia’s National Health Insurance, reported that there was an increase in deficit in the 4 years of the implementation of National Health Insurance from US$ 228 million in 2014 to US$ 470 million in 2016. Despite efforts conducted to overcome the problem, no evidence-based predictor that might be significantly associated with moral hazard in a rural province hospital in Indonesia. The purpose of this research is to identify the incidence of moral hazard in the implementation of National Health Insurance in Indonesia. Data consisting of 180 medical records obtained from three public hospitals in rural province of Indonesia were selected as samples in this study. These medical records were reviewed by Independent Senior Coder (ISC) who had more than 5 years experiences as a coder. The indicators of moral hazard in this study were upcoding, readmission, and possible unnecessary admission. Logistic regression was used to explore determinant of moral hazard from patient, coder, and physician side. The results show that rate of moral hazard cases for upcoding is 10%, readmission is 2.8%, and possible unnecessary admission is 18.9%. It can be seen from multivariate analysis that discharge status, severity level and LOS have a significant relationship with moral hazard. Illness severity level, Discharge against Medical Advice, and higher Length of Stay are risk factors for moral hazard incidence.

THE EFFECT OF INVESTIGATIVE, INDEPENDENT AUDIT AND DUE PROFESSIONAL CARE AUDITS ON THE EFFECTIVENESS OF THE IMPLEMENTATION OF FRAUD PROCEDURES MODERATED BY SOCIAL PRESSURE IN THE INTERNAL AUDIT DEPARTMENT OF PT. INDOAGUNG MULTIKREASI CERAMIC INDUSTRI & PT. WIJAYA DISTRIBUTION Dede Rahmat; Eko Gumaya Sari
Asia Pacific Fraud Journal Vol 5, No 1: Volume 5, No. 1st Edition (January-June 2020)
Publisher : Association of Certified Fraud Examiners Indonesia Chapter

This research is a study on "The Effect of Investigative Audit, Independent Audit and Due Professional Care Verification Procedures for Implementation Effectiveness Against Fraud which in moderation by Social Pressure". The dependent variable in this study is the Effectiveness of Implementation of Era Fraud (Fraud) Procedures, while the independent variable is the Investigative Audit, Independent Audit and Due Professional Care. Moderating variables using variable Social Pressure. The Internal Audit Department of PT. Indoagung Multikreasi Ceramic Industry. Samples that meet the criteria are as many as 60 respondents. A couple of stages. The first stage is to explore the theory of formulation of research problems and hypotheses. The second stage is the collection of data from the unit of analysis is researched. The Descriptive Test and Reliability Test, the fourth stage of the research hypothesis testing using multiple regression to test the hypothesis either partially or simultaneously. The fifth stage is the Social Pressure testing of the moderating effect, not weaken or diminished the effect of the Audit and Due Professional Care Verification Procedures of the Implementation Effectiveness Against Fraud (Fraud). The significant effect on the effect of the implementation of the procedure is that there is a significant effect on the effectiveness of the procedure. Effectiveness of the Implementation Procedures of Evidence Fraud (Fraud). Simultaneously Investigative Audit Variables, Independent Audit and Due Care Professionals have significant effects on the procedures for Implementation of Evidence Fraud (fraud). Moderation of Social Pressure Able to weaken the influence of Investigative Audit, Independent Audit and Due Professional Care of the Effectiveness of the Implementation Procedures of Evidence Fraud (fraud)

FRAUD AND WHISTLEBLOWING IN THE MANAGEMENT OF STUDENT FUNDS Aprina Nugrahesthy Sulistya Hapsari; Edi Supriyono
Asia Pacific Fraud Journal Vol 5, No 1: Volume 5, No. 1st Edition (January-June 2020)
Publisher : Association of Certified Fraud Examiners Indonesia Chapter

The aim of this study was to find out whether there is the potential for fraud and whistleblowing in the management of student funds as a way to detect fraud in universities. The type of research used in this study was descriptive qualitative research. Data collection was done through interviews, observation, and documentation. This study was conducted at one of universities located in Central Java by describing several variables including fraud, whistleblowing and management of student funds.. The data was analyzed using fraud triangle framework and the fraud scheme based on the ACFE classification. The results of this study show that in the management of student funds there was the potential for fraud, such as misuse of financial statements and corruption. There was indication of fraud, but it did not happen. Potential for whistleblowing was not found because they assume that if fraud occurs it is better to discuss it in a family manner and will not report it.

ANALYSIS OF THE READINESS OF INDONESIAN PEOPLE AND REGULATIONS IN HANDLING FRAUD ON TECHNOLOGY EXPLOITATION Mustika Prabaningrum Kusumawati; Ari Nur Rahman; Panzi Aulia Rahman; Henry Adrian Sumule; Endrojoyo Sigit Triyono
Asia Pacific Fraud Journal Vol 5, No 1: Volume 5, No. 1st Edition (January-June 2020)
Publisher : Association of Certified Fraud Examiners Indonesia Chapter

The development of information technology has a big influence in supporting business continuity among producers, consumers, distributors, and financial service institutions. The development of Financial Technology (Fintech) has now become a trend in modern society that follows the current developments. The positive side of technological development, especially in supporting fast and smooth financial services, can actually create a large gap in the readiness of the use of technology in the industrial revolution 4.0. Without strong preparation, this will increasingly create a big gap in the formation of the Fintech technology-based fraud chain. This paper discusses how a qualitative research using the grounded research model can find out the use of recht vacuum loopholes to commit fraud in the exploitation of technology. In addition, it also encourages the establishment of a regulation that supports the creation of a healthy Fintech ecosystem which is the main key in increasing Indonesia's economic growth. Factors influencing the occurrence of fraud include the lack of public knowledge about how to transact using Fintech, the looseness of applicable regulations, the arrogance of Fintech consumer in utilizing bug software Fintech to get profit as much as possible without thinking about legal consequences, the arrogance of the Fintech company in minimizing the large risks that will occur, and not maximum formation of the Fintech ecosystem with other traditional financial service institutions. The situation is exacerbated by the unavailability of the Whistleblowing System (WBS) through a complaint channel specifically for Fintech. The establishment of the Fintech ecosystem, with the adoption of an anti-fraud system as one of the factors that drive Indonesia's economic growth, can be done by creating a technology-savvy community, especially Fintech; making an integrity pact to support anti-fraud and anti-money laundering among regulators, the Fintech association, and the Fintech companies at the time of making official registration with the regulator; Regulators need to get rid of egotism between institutions by synchronizing verbally or nonverbally through technology channels that are automatically integrated between state institutions and preparing special channels for whistleblower systems or consumer complaints channel specifically for Fintech.

THE WAY THE LOCAL GOVERNMENT WORKS TO FIGHT AGAINST CORRUPTION IN KUPANG CITY IN THE PERSPECTIVES OF GENERATIONS X AND Y Friandry Windisany Thoomaszen; Sance Mariana Tameon
Asia Pacific Fraud Journal Vol 5, No 1: Volume 5, No. 1st Edition (January-June 2020)
Publisher : Association of Certified Fraud Examiners Indonesia Chapter

Generations Y and Z are the next generations of the Indonesian nation, including in the process of preventing and eradicating corruption. These two generations tend to have the same weaknesses, that is, the tendency to be apathetic towards the government and politics. This apathy can be an obstacle to eradicating corruption cases in the future when these generations occupy strategic positions. The aim of the study is to find out the views of generations Y and Z on the way the local government works to eradicate corruption cases in Kupang City. The researchers use a quantitative approach, with descriptive survey research methods. The research subjects are 78 Christians from the generation Y and Z who live in Kupang City. The sampling technique used is stratified random sampling which is spread using the google forms (online) format. The results of the study show that generation Y and Z are sensitive to cases of corruption that are taking place in their domicile, Kupang City. Out of 78 subjects of generation Y and Z, the majority or 42 subjects answer that the level of corruption in Kupang City is at a severe level. Generation Z also looks more familiar with Nine anti-corruption values than generation Y. There are various solutions offered by generations Y and Z for regional leaders to overcome corruption in Kupang City. However, the solution to the campaign is still considered to be less effective in dealing with corruption for generation Y and Z. It is recommended that local governments see and use the opinions of generation Y and Z to improve themselves and the anti-corruption system and involve generation Y and Z to prevent, fight, and eradicate corruption cases actively both in real actions and in cyberspace (social media). Anti-corruption behavior conveyed to generations Y and Z must be more attractive, modern, and in accordance with the characteristics of these two generations who have a dependency on cyberspace.

FRAUD RISK MANAGEMENT: AN ANTI-FRAUD MODEL FOR TOURIST ACCOMMODATION IN BALI Nyoman Sunarti; Putu Sukma Kurniawan; Edy Sujana; I Nyoman Putra Yasa
Asia Pacific Fraud Journal Vol 5, No 1: Volume 5, No. 1st Edition (January-June 2020)
Publisher : Association of Certified Fraud Examiners Indonesia Chapter

This study aims to examine fraud in hotels by developing a Fraud Risk Management (FRM) design. FRM is developed through several stages, including preliminary analysis, preparing the initial design of the FRM, testing the implementation, making correction, and preparing the final design of the FRM. The research method used in this study is a qualitative method by combining Research and Development (R&D) methods. Data collection is done through interview, observation, and documentation techniques. Data analysis method is carired out through data reduction, data presentation, and drawing conclusions. The data sources used in this study are primary data and secondary data. The results of this study show that basically both types of hotels have the same potential for fraud but with different business processes. The FRM design implemented can be divided into 2: general design and specific design. There are some corrections which can finally result in FRM design in accordance with the conditions of each hotel.

INCIDENCE AND ROOT CAUSE OF UPCODING IN THE IMPLEMENTATION OF SOCIAL HEALTH INSURANCE IN RURAL PROVINCE HOSPITAL IN INDONESIA Syafrawati Syafrawati; Rizanda Machmud; Prof. Syed Mohammed Aljunid; Rima Semiarty
Asia Pacific Fraud Journal Vol 5, No 1: Volume 5, No. 1st Edition (January-June 2020)
Publisher : Association of Certified Fraud Examiners Indonesia Chapter

Upcoding is one of important indicators of moral hazard and fraud in Social Health Insurance scheme. However, there seems to be little evidence about incidence of upcoding and how upcoding occurs in hospital, especially in rural province hospital. The objective of this study is to determine incidence and root cause of upcoding in the implementation of Social Health Insurance in Rural Province Hospital in Indonesia. The data used in this study were both qualitative and quantitative data (mixed method). Three hundred and sixty (360) inpatient medical records from six rural province hospitals were examined in this study. Diagnosis and procedure codes recorded in these medical records were re-coded by an independent senior coder (ISC). Codes from hospitals’ coders and codes from ISC were then re-grouped using INA-CBG casemix grouper to determine the casemix groups and the hospital tariffs. If the hospital tariff obtained by hospital coder is higher than that obtained by ISC, it is considered as upcoding. This qualitative study was conducted using Focus Group Discussion (FGD) and in-depth interviews in hospitals located in a rural province of Indonesia. In depth interview was held for two hospital directors and two officers from the Social Security Administrator (Indonesia: BadanPenyelenggaraJaminanSosial/BPJS), an agent that manages the Statutory Health Insurance (SHI). Six clinicians and six coders attended the FGD. We asked open-ended questions about their perceptions on upcoding in hospitals. The interviews were recorded and transcribed verbatim. The transcripts were then thematically analyzed. Upcoding cases were found in 11.9% (43/360) medical records. Upcoding cases were dominated by Deliveries Group 2.8% (10/360) and Female reproductive system Groups 1.7% (6/360). The potential loss of income due to upcoding was IDR 154.626.000 or 9% of hospital revenue. Appointment of non-medical doctors as internal verifiers, lack of clear coding guidelines, lack of training for doctors and coders, and poor coordination between hospital and BPJS to resolve coding disagreement were root causes of upcoding in hospital. Policies to prevent and manage upcoding should be urgently developed and implemented in the Statutory Health Insurance (SHI) program in Indonesia especially to prepare upcoding guidelines, enhance medical coding trainingregularly, increase number of coders and verification staff from medical background, and strengthen coordination for coding problem solving in hospital.

HUMANITY IN THE ENFORCEMENT OF ANTI-CORRUPTION LAWS Tomy Michael
Asia Pacific Fraud Journal Vol 5, No 2: Volume 5, No. 2nd Edition (July-December 2020)
Publisher : Association of Certified Fraud Examiners Indonesia Chapter

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21532/apfjournal.v5i2.162

The justice of the law in the context of the law always subjected to refraction meaning. The justice of law can’t be interpreted as specific but can be shown through deeds. The justice of the law which is considered better by most people not necessarily also have the same feeling with the justice of the law. There are various dimensions to distinguish it. In the context of the state, the leader is the main pedestal of enforcing the law on the laws and regulations in there. When the leader of a country is it where it as full support to the state institutions that overcome the problems of corruption, namely the Corruption Eradication Commission and the whole thing can run optimally. Advice taken, namely by forming laws and regulations based on humanity with other humans, namely the variation of the judgment. The judgment referred to is social work, exile to the island of the smallest, lethal injection and impoverishment through from the first of assets appropriately. Thus, humanity in enforcing anti-corruption laws can be run better by paying attention to the humanity of the injured party.

Characteristics Affecting Anti-corruption Behavior in Indonesia Ahmad Kosasih
Asia Pacific Fraud Journal Vol 6, No 1: Volume 6, No. 1st Edition (January-June 2021)
Publisher : Association of Certified Fraud Examiners Indonesia Chapter

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21532/apfjournal.v6i1.203

The problem of corruption in Indonesia at this time is nothing new in the midst of Indonesian people. Low integrity and permissive culture of corruption are suspected to be the cause of the development of corrupt practices. The Indonesia Anti-Corruption Behavior Index (ACBI)) compiled by Statistics Indonesia (Indonesia: BadanPusatStatistik / BPS) is used to obtain a complete picture of the current situation and conditions of community anti-corruption behavior. This study aims to determine the characteristics that differentiate Anti-Corruption Behavior Index (ACBI)scores. The analytical method used is descriptive and non-parametric analysis to determine differences in ACBI seen from other dimensions and characteristics such as residential area, education level, and age group. In general, ACBI in Indonesia has continued to increase from 2012 and reached the highest moment in 2020, amounting to 3.91 in the category of very anti-corruption. The dimensions and characteristics of the area of residence and the level of education have significant differences in ACBI, while the age groups do not have differences in ACBI. Policies in an effort to improve anti-corruption behavior of the community need to pay attention to dimensions and characteristics that have significant differences so that the policies implemented can be right on target.

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Dr. Tarjo

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