Auditoría Forense como mecanismo de prevención y detección de fraude financiero: Estudio de caso, Grupo Go Más Vida IPS S.A.S., Sede Bucaramanga

Abstract

The Colombian healthcare sector faces a structural crisis marked by corruption and financial fraud. The Comptroller General of the Republic has reported the misappropriation of over nine trillion pesos from the system between 2020 and 2021, through more than 70 different types of fraud. In light of the above, this document analyzes the Forensic Audit process as a mechanism for preventing and detecting financial fraud and its impact on the financial security of the Go Más Vida IPS S.A.S. Group. Methodologically, it was a descriptive-analytical study with a qualitative case study approach, employing triangulation of both primary and secondary sources. The results identified deficiencies in document traceability, inconsistencies in accounting reports, errors in records and late payments, and frauds such as record manipulation, altered billing, and document forgery, with tax avoidance being the most frequent. In conclusion, although no illicit acts have been committed within the organization, the weaknesses found demonstrate the need to institutionalize Forensic Auditing as a financial security policy, through technological strengthening, training in ethics and integrity, updating of risk matrices, and the periodic performance of integrated audits.