Care Alliance Health Center, Inc. respectfully submits the following corrective action plan for the year ended October 31, 2025. CohnReznick LLP 350 Church Street Hartford, CT 06103 Audit Period: October 31, 2025 The findings from the October 31, 2025 schedule of findings and questioned costs are disc...
Care Alliance Health Center, Inc. respectfully submits the following corrective action plan for the year ended October 31, 2025. CohnReznick LLP 350 Church Street Hartford, CT 06103 Audit Period: October 31, 2025 The findings from the October 31, 2025 schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the number assigned in the schedule. Federal Award Findings: Finding 2025.001 - Special Tests and Provisions - Sliding Fee Scale Documentation Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated and supported based on family size and income. Action Taken FY 2025 Corrective Actions and Objectives Documented Process, Procedures and Policies • By June 30, 2026, Care Alliance will update, standardize, and implement a unified, documented workflow for full-fee collection at check-in for all encounters. • Key Performance Indicators (KPI) • ≥90% of self-pay encounters have documented collection attempt • 100% of quarterly review cycles by October 31, 2026. • By April 15, 2026, Finance and Operations will develop a concise list of commonly used CPT/HCPCS procedure codes with associated full fee amounts for Patient Services Representatives (PSRs). The list will be updated quarterly. • KPIs • 100% staff acknowledgment of list each quarter • ≥85% accurate fee quotes of random sampling • By May 1, 2026, Finance and Operations will review and update finance policies governing full-payment determination and collections (FS 106 Sliding Fee Scale Discount Program and FS 107 Billing, Credit, and Collection). • KPIs • 100% staff acknowledgment of updated policies • ≥95% compliant monthly audit of SFS documentation (random sampling) Training and Education • By June 30, 2026, Care Alliance will provide training to front desk staff members responsible for determining eligibility and applying sliding fee discounts. Training will cover documentation requirements, verification of family size/income, and correct SFS application. • KPIs • 100% Staff Training and Education Sign- Off • 100% Completion of annual competency for SFS • By May 31, 2026, Operations will implement a process that ensures Sliding Fee Scale (SFS)/self-pay indicators, Federal Poverty Level (FPL) are accurately entered and maintained for all visits, across all guarantor accounts. • KPIs • ≥90% of self-pay encounters have documented collection attempt • ≥85% accurate fee quotes of random sampling • By April 30, 2026, PSR will use standardized documentation during collections (amount owed, partial payments, attempts, patient ability to pay) for every applicable visit and incorporate into monthly audits. • KPIs • ≥90% documentation compliance of sampled encounters • By July 31, 2026, Finance will clarify treatment and procedures of bad debt previously written off and integrate post-write-off recovery efforts into policy and monthly reporting. • KPIs • 100% staff acknowledgment of updated policies Review and Auditing By May 1, 2026, and continuing throughout FY26, the Revenue Cycle Manager and Controller will conduct monthly audits to verify that all Sliding Fee Scale (SFS) discounts are accurately calculated, properly supported, and fully documented in accordance with FS 106. Additionally, the Controller will conduct quarterly reviews to evaluate overall compliance, identify areas for improvement, and assess the effectiveness of the sliding scale fee program in meeting patient needs and federal guidelines. Responsible Parties and Reporting Cadence • Controller and Director of Operations: Owns policy updates (FS 106/FS 107), quarterly documentation reviews, and oversight of FPL table updates. • Revenue Cycle Manager: Monitors adherence to workflow, conducts monthly audits, and drives corrective actions with Clinical Support Manager. Maintains the common procedures fee list and coordinates quarterly updates. • Clinical Support/Patient Access Manager (PSR Manager): Oversees PSR training, documentation compliance, and daily operations. Provides staff coaching and remediation based on monthly audit results. If there are any question regarding this plan, please e-mail Dr. Derrick Howell at dhowell@carealliance.org. Sincerely, Dr. Derrick Howell CFO