Audit 17677

Criteria or specific requirement- Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted based on the patient's ability to pay as follows: a) Sliding fee discounts are applied to fees for health center services provided to all individuals and families with annual incomes at or below 200 percent of the Federal Poverty Guidelines (FPG); b) A full discount is applied to fees for health center services provided to individuals and families with annual incomes at or below 100 percent of the FPG, or the health center applies only a nominal charge; c) Fees for health center services are discounted based on gradations in family size and income for individuals and families with incomes above 100 and at or below 200 percent of the FPG; and d) No sliding fee discount is applied to fees for health center services provided to individuals and families with annual incomes above 200 percent of the FPG. Condition - During the compliance testing of the Uniform Guidance "Special Tests and Provisions - Sliding Fee Discounts" one (1) selection out of a sample size of twenty-five (25) did not have the correct sliding fee applied to their services. Questioned Costs - None. Effect - The patient was not charged the correct amount for the services that were performed based on income information provided. Cause - Proof of income information was properly obtained from the patient, however, the information was not input into the billing system correctly so the sliding fee was not properly applied. Recommendation - Management should ensure that all information is input into the billing system correctly in order to avoid patients getting charged incorrect amounts for services. Management's Response - Management has already begun working to ensure that this does not happen again. Management feels as though this is partially due to using a third party to assist with billing and has plans to bring billing back in house where it can be better monitored. Billing is expected to be completely back in house by March 31, 2023.

Criteria or specific requirement- Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted based on the patient's ability to pay as follows: a) Sliding fee discounts are applied to fees for health center services provided to all individuals and families with annual incomes at or below 200 percent of the Federal Poverty Guidelines (FPG); b) A full discount is applied to fees for health center services provided to individuals and families with annual incomes at or below 100 percent of the FPG, or the health center applies only a nominal charge; c) Fees for health center services are discounted based on gradations in family size and income for individuals and families with incomes above 100 and at or below 200 percent of the FPG; and d) No sliding fee discount is applied to fees for health center services provided to individuals and families with annual incomes above 200 percent of the FPG. Condition - During the compliance testing of the Uniform Guidance "Special Tests and Provisions - Sliding Fee Discounts" one (1) selection out of a sample size of twenty-five (25) did not have the correct sliding fee applied to their services. Questioned Costs - None. Effect - The patient was not charged the correct amount for the services that were performed based on income information provided. Cause - Proof of income information was properly obtained from the patient, however, the information was not input into the billing system correctly so the sliding fee was not properly applied. Recommendation - Management should ensure that all information is input into the billing system correctly in order to avoid patients getting charged incorrect amounts for services. Management's Response - Management has already begun working to ensure that this does not happen again. Management feels as though this is partially due to using a third party to assist with billing and has plans to bring billing back in house where it can be better monitored. Billing is expected to be completely back in house by March 31, 2023.

Criteria or specific requirement- Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted based on the patient's ability to pay as follows: a) Sliding fee discounts are applied to fees for health center services provided to all individuals and families with annual incomes at or below 200 percent of the Federal Poverty Guidelines (FPG); b) A full discount is applied to fees for health center services provided to individuals and families with annual incomes at or below 100 percent of the FPG, or the health center applies only a nominal charge; c) Fees for health center services are discounted based on gradations in family size and income for individuals and families with incomes above 100 and at or below 200 percent of the FPG; and d) No sliding fee discount is applied to fees for health center services provided to individuals and families with annual incomes above 200 percent of the FPG. Condition - During the compliance testing of the Uniform Guidance "Special Tests and Provisions - Sliding Fee Discounts" one (1) selection out of a sample size of twenty-five (25) did not have the correct sliding fee applied to their services. Questioned Costs - None. Effect - The patient was not charged the correct amount for the services that were performed based on income information provided. Cause - Proof of income information was properly obtained from the patient, however, the information was not input into the billing system correctly so the sliding fee was not properly applied. Recommendation - Management should ensure that all information is input into the billing system correctly in order to avoid patients getting charged incorrect amounts for services. Management's Response - Management has already begun working to ensure that this does not happen again. Management feels as though this is partially due to using a third party to assist with billing and has plans to bring billing back in house where it can be better monitored. Billing is expected to be completely back in house by March 31, 2023.

Criteria or specific requirement- Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted based on the patient's ability to pay as follows: a) Sliding fee discounts are applied to fees for health center services provided to all individuals and families with annual incomes at or below 200 percent of the Federal Poverty Guidelines (FPG); b) A full discount is applied to fees for health center services provided to individuals and families with annual incomes at or below 100 percent of the FPG, or the health center applies only a nominal charge; c) Fees for health center services are discounted based on gradations in family size and income for individuals and families with incomes above 100 and at or below 200 percent of the FPG; and d) No sliding fee discount is applied to fees for health center services provided to individuals and families with annual incomes above 200 percent of the FPG. Condition - During the compliance testing of the Uniform Guidance "Special Tests and Provisions - Sliding Fee Discounts" one (1) selection out of a sample size of twenty-five (25) did not have the correct sliding fee applied to their services. Questioned Costs - None. Effect - The patient was not charged the correct amount for the services that were performed based on income information provided. Cause - Proof of income information was properly obtained from the patient, however, the information was not input into the billing system correctly so the sliding fee was not properly applied. Recommendation - Management should ensure that all information is input into the billing system correctly in order to avoid patients getting charged incorrect amounts for services. Management's Response - Management has already begun working to ensure that this does not happen again. Management feels as though this is partially due to using a third party to assist with billing and has plans to bring billing back in house where it can be better monitored. Billing is expected to be completely back in house by March 31, 2023.

Criteria or specific requirement- Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted based on the patient's ability to pay as follows: a) Sliding fee discounts are applied to fees for health center services provided to all individuals and families with annual incomes at or below 200 percent of the Federal Poverty Guidelines (FPG); b) A full discount is applied to fees for health center services provided to individuals and families with annual incomes at or below 100 percent of the FPG, or the health center applies only a nominal charge; c) Fees for health center services are discounted based on gradations in family size and income for individuals and families with incomes above 100 and at or below 200 percent of the FPG; and d) No sliding fee discount is applied to fees for health center services provided to individuals and families with annual incomes above 200 percent of the FPG. Condition - During the compliance testing of the Uniform Guidance "Special Tests and Provisions - Sliding Fee Discounts" one (1) selection out of a sample size of twenty-five (25) did not have the correct sliding fee applied to their services. Questioned Costs - None. Effect - The patient was not charged the correct amount for the services that were performed based on income information provided. Cause - Proof of income information was properly obtained from the patient, however, the information was not input into the billing system correctly so the sliding fee was not properly applied. Recommendation - Management should ensure that all information is input into the billing system correctly in order to avoid patients getting charged incorrect amounts for services. Management's Response - Management has already begun working to ensure that this does not happen again. Management feels as though this is partially due to using a third party to assist with billing and has plans to bring billing back in house where it can be better monitored. Billing is expected to be completely back in house by March 31, 2023.

Criteria or specific requirement- Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted based on the patient's ability to pay as follows: a) Sliding fee discounts are applied to fees for health center services provided to all individuals and families with annual incomes at or below 200 percent of the Federal Poverty Guidelines (FPG); b) A full discount is applied to fees for health center services provided to individuals and families with annual incomes at or below 100 percent of the FPG, or the health center applies only a nominal charge; c) Fees for health center services are discounted based on gradations in family size and income for individuals and families with incomes above 100 and at or below 200 percent of the FPG; and d) No sliding fee discount is applied to fees for health center services provided to individuals and families with annual incomes above 200 percent of the FPG. Condition - During the compliance testing of the Uniform Guidance "Special Tests and Provisions - Sliding Fee Discounts" one (1) selection out of a sample size of twenty-five (25) did not have the correct sliding fee applied to their services. Questioned Costs - None. Effect - The patient was not charged the correct amount for the services that were performed based on income information provided. Cause - Proof of income information was properly obtained from the patient, however, the information was not input into the billing system correctly so the sliding fee was not properly applied. Recommendation - Management should ensure that all information is input into the billing system correctly in order to avoid patients getting charged incorrect amounts for services. Management's Response - Management has already begun working to ensure that this does not happen again. Management feels as though this is partially due to using a third party to assist with billing and has plans to bring billing back in house where it can be better monitored. Billing is expected to be completely back in house by March 31, 2023.

Criteria or specific requirement- Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted based on the patient's ability to pay as follows: a) Sliding fee discounts are applied to fees for health center services provided to all individuals and families with annual incomes at or below 200 percent of the Federal Poverty Guidelines (FPG); b) A full discount is applied to fees for health center services provided to individuals and families with annual incomes at or below 100 percent of the FPG, or the health center applies only a nominal charge; c) Fees for health center services are discounted based on gradations in family size and income for individuals and families with incomes above 100 and at or below 200 percent of the FPG; and d) No sliding fee discount is applied to fees for health center services provided to individuals and families with annual incomes above 200 percent of the FPG. Condition - During the compliance testing of the Uniform Guidance "Special Tests and Provisions - Sliding Fee Discounts" one (1) selection out of a sample size of twenty-five (25) did not have the correct sliding fee applied to their services. Questioned Costs - None. Effect - The patient was not charged the correct amount for the services that were performed based on income information provided. Cause - Proof of income information was properly obtained from the patient, however, the information was not input into the billing system correctly so the sliding fee was not properly applied. Recommendation - Management should ensure that all information is input into the billing system correctly in order to avoid patients getting charged incorrect amounts for services. Management's Response - Management has already begun working to ensure that this does not happen again. Management feels as though this is partially due to using a third party to assist with billing and has plans to bring billing back in house where it can be better monitored. Billing is expected to be completely back in house by March 31, 2023.

Criteria or specific requirement- Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted based on the patient's ability to pay as follows: a) Sliding fee discounts are applied to fees for health center services provided to all individuals and families with annual incomes at or below 200 percent of the Federal Poverty Guidelines (FPG); b) A full discount is applied to fees for health center services provided to individuals and families with annual incomes at or below 100 percent of the FPG, or the health center applies only a nominal charge; c) Fees for health center services are discounted based on gradations in family size and income for individuals and families with incomes above 100 and at or below 200 percent of the FPG; and d) No sliding fee discount is applied to fees for health center services provided to individuals and families with annual incomes above 200 percent of the FPG. Condition - During the compliance testing of the Uniform Guidance "Special Tests and Provisions - Sliding Fee Discounts" one (1) selection out of a sample size of twenty-five (25) did not have the correct sliding fee applied to their services. Questioned Costs - None. Effect - The patient was not charged the correct amount for the services that were performed based on income information provided. Cause - Proof of income information was properly obtained from the patient, however, the information was not input into the billing system correctly so the sliding fee was not properly applied. Recommendation - Management should ensure that all information is input into the billing system correctly in order to avoid patients getting charged incorrect amounts for services. Management's Response - Management has already begun working to ensure that this does not happen again. Management feels as though this is partially due to using a third party to assist with billing and has plans to bring billing back in house where it can be better monitored. Billing is expected to be completely back in house by March 31, 2023.