Audit 345296

Criteria: Health centers that receive funding under ALN 93.224 – Health Center Program, are required to prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted based on the patient’s ability to pay. Condition: During testing of the application of the Network’s slide scale fees, we noticed that 4 out of 71 testing selections applied a fee that was lower than the slide for which the patient qualified. Cause: In one of the four exceptions, there was an incorrect recording of the patient’s income on the slide determination documentation. The other three exceptions were due to the wrong slide being applied to a patient’s account where the slide-level qualifications had been properly documented. Effect: The pervasiveness and amount of these errors were projected to the entire population resulting in an estimated $1,895 which sliding patients were undercharged. Recommendation: We recommend that the Network implement a more robust review process for information that is input into the billing system. Auditor’s Conclusion: Because the amount of the error is trivial to the major program, this finding does not constitute a material weakness but is a control deficiency that requires attention to strengthen the accuracy of the application of the slide scale fees.

Criteria: Health centers that receive funding under ALN 93.224 – Health Center Program, are required to prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted based on the patient’s ability to pay. Condition: During testing of the application of the Network’s slide scale fees, we noticed that 4 out of 71 testing selections applied a fee that was lower than the slide for which the patient qualified. Cause: In one of the four exceptions, there was an incorrect recording of the patient’s income on the slide determination documentation. The other three exceptions were due to the wrong slide being applied to a patient’s account where the slide-level qualifications had been properly documented. Effect: The pervasiveness and amount of these errors were projected to the entire population resulting in an estimated $1,895 which sliding patients were undercharged. Recommendation: We recommend that the Network implement a more robust review process for information that is input into the billing system. Auditor’s Conclusion: Because the amount of the error is trivial to the major program, this finding does not constitute a material weakness but is a control deficiency that requires attention to strengthen the accuracy of the application of the slide scale fees.