Audit 24254

Federal Program: Assistance Listing # 93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: We tested 60 sliding fee encounters and noted that 2 of 60 sliding fee encounters tested had incorrect sliding fee discounts applied. In addition, 1 out of 60 sliding fee encounters was missing an application and 3 of 60 sliding fee encounters were missing employee approving signatures on the applications. Questioned Costs: None. Cause: The Organization did not properly bill the sliding fee discount based on information provided in the application or did not properly document approved applications. Effect: The Organization may have incorrectly charged the client for the services provided. Recommendation: We recommend that sliding fee billings be applied based on the application data in accordance with the sliding discount schedule and verify that patient charges agree to the calculated amount. Procedures should be implemented to verify sliding fee discounts at the time of billing to ensure all are accurate when originally billed. In addition, the Organization could consider doing sampling throughout the year to verify sliding fee charges are correct. View of Responsible Officials: Management is in agreement with the finding. Corrective Action Plan: See attached corrective action plan.

Federal Program: Assistance Listing # 93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: We tested 60 sliding fee encounters and noted that 2 of 60 sliding fee encounters tested had incorrect sliding fee discounts applied. In addition, 1 out of 60 sliding fee encounters was missing an application and 3 of 60 sliding fee encounters were missing employee approving signatures on the applications. Questioned Costs: None. Cause: The Organization did not properly bill the sliding fee discount based on information provided in the application or did not properly document approved applications. Effect: The Organization may have incorrectly charged the client for the services provided. Recommendation: We recommend that sliding fee billings be applied based on the application data in accordance with the sliding discount schedule and verify that patient charges agree to the calculated amount. Procedures should be implemented to verify sliding fee discounts at the time of billing to ensure all are accurate when originally billed. In addition, the Organization could consider doing sampling throughout the year to verify sliding fee charges are correct. View of Responsible Officials: Management is in agreement with the finding. Corrective Action Plan: See attached corrective action plan.

Federal Program: Assistance Listing # 93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: We tested 60 sliding fee encounters and noted that 2 of 60 sliding fee encounters tested had incorrect sliding fee discounts applied. In addition, 1 out of 60 sliding fee encounters was missing an application and 3 of 60 sliding fee encounters were missing employee approving signatures on the applications. Questioned Costs: None. Cause: The Organization did not properly bill the sliding fee discount based on information provided in the application or did not properly document approved applications. Effect: The Organization may have incorrectly charged the client for the services provided. Recommendation: We recommend that sliding fee billings be applied based on the application data in accordance with the sliding discount schedule and verify that patient charges agree to the calculated amount. Procedures should be implemented to verify sliding fee discounts at the time of billing to ensure all are accurate when originally billed. In addition, the Organization could consider doing sampling throughout the year to verify sliding fee charges are correct. View of Responsible Officials: Management is in agreement with the finding. Corrective Action Plan: See attached corrective action plan.

Federal Program: Assistance Listing # 93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: We tested 60 sliding fee encounters and noted that 2 of 60 sliding fee encounters tested had incorrect sliding fee discounts applied. In addition, 1 out of 60 sliding fee encounters was missing an application and 3 of 60 sliding fee encounters were missing employee approving signatures on the applications. Questioned Costs: None. Cause: The Organization did not properly bill the sliding fee discount based on information provided in the application or did not properly document approved applications. Effect: The Organization may have incorrectly charged the client for the services provided. Recommendation: We recommend that sliding fee billings be applied based on the application data in accordance with the sliding discount schedule and verify that patient charges agree to the calculated amount. Procedures should be implemented to verify sliding fee discounts at the time of billing to ensure all are accurate when originally billed. In addition, the Organization could consider doing sampling throughout the year to verify sliding fee charges are correct. View of Responsible Officials: Management is in agreement with the finding. Corrective Action Plan: See attached corrective action plan.

Federal Program: Assistance Listing # 93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: We tested 60 sliding fee encounters and noted that 2 of 60 sliding fee encounters tested had incorrect sliding fee discounts applied. In addition, 1 out of 60 sliding fee encounters was missing an application and 3 of 60 sliding fee encounters were missing employee approving signatures on the applications. Questioned Costs: None. Cause: The Organization did not properly bill the sliding fee discount based on information provided in the application or did not properly document approved applications. Effect: The Organization may have incorrectly charged the client for the services provided. Recommendation: We recommend that sliding fee billings be applied based on the application data in accordance with the sliding discount schedule and verify that patient charges agree to the calculated amount. Procedures should be implemented to verify sliding fee discounts at the time of billing to ensure all are accurate when originally billed. In addition, the Organization could consider doing sampling throughout the year to verify sliding fee charges are correct. View of Responsible Officials: Management is in agreement with the finding. Corrective Action Plan: See attached corrective action plan.

Federal Program: Assistance Listing # 93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: We tested 60 sliding fee encounters and noted that 2 of 60 sliding fee encounters tested had incorrect sliding fee discounts applied. In addition, 1 out of 60 sliding fee encounters was missing an application and 3 of 60 sliding fee encounters were missing employee approving signatures on the applications. Questioned Costs: None. Cause: The Organization did not properly bill the sliding fee discount based on information provided in the application or did not properly document approved applications. Effect: The Organization may have incorrectly charged the client for the services provided. Recommendation: We recommend that sliding fee billings be applied based on the application data in accordance with the sliding discount schedule and verify that patient charges agree to the calculated amount. Procedures should be implemented to verify sliding fee discounts at the time of billing to ensure all are accurate when originally billed. In addition, the Organization could consider doing sampling throughout the year to verify sliding fee charges are correct. View of Responsible Officials: Management is in agreement with the finding. Corrective Action Plan: See attached corrective action plan.