Finding 2022-001 ? Activities Allowed or Unallowed, Eligibility, and Special Tests and Provisions Information on the federal program: Federal Grantor: United States Department of Health and Human Services, Health Resources and Services Administration (HRSA) Assistance Listing No.: 93.461, COVID-19 T...
Finding 2022-001 ? Activities Allowed or Unallowed, Eligibility, and Special Tests and Provisions Information on the federal program: Federal Grantor: United States Department of Health and Human Services, Health Resources and Services Administration (HRSA) Assistance Listing No.: 93.461, COVID-19 Testing for the Uninsured Pass-Through Award Numbers: Not applicable Pass-Through Award Period of Performance: 01/01/2022?3/31/2022 Views of responsible officials and planned corrective actions: Management agrees with the finding. Our standard procedure is to verify insurance coverage for all patients. We believe in instances where documentation was not maintained to evidence that additional insurance verification procedures were performed in addition to the standard patient inquiry, such instances were a documentation error and not a process issue. Since the federal program has ended, no further action will be taken. Management has noted that in certain instances, patients identify themselves as uninsured but following their date of service, AdventHealth identified that the patient either had insurance coverage or was eligible for Medicaid. AdventHealth was not aware that the patient had insurance coverage and requested reimbursement from HRSA, prior to AdventHealth identifying insurance coverage. AdventHealth has processed a refund to HRSA, in instances where reimbursement was received from another payer or another payer was available to provide reimbursement. Documentation was established effective September 30, 2022, to evidence the operating effectiveness of internal controls in place over balance billing. Responsible official: Stacey Wilson, Director Grants Management