Finding Text
U.S. Department of Health and Human Services
Assistance Listing Number 93.224 and 93.527
Health Center Program Cluster
Criteria or Specific Requirement – Special Tests and Provisions: Sliding Fee Discounts
Condition – Patients did not receive the proper sliding fee adjustments under the
Organization’s policy.
Questioned Cost – None
Context – A sample of 40 patients were tested out of the total population of 3,642
encounters. Six patients did not receive the proper sliding fee adjustments. The sampling
methodology used is not and is not intended to be statistically valid.
Effect – Incorrect sliding fee discounts were given in the sample selected for testing.
Cause – The Organization did not comply with its sliding fee policy.
Identification as a Repeat Finding – Yes
Recommendation – We recommend management continue to ensure all personnel
understand the sliding fee scale policy and adhere to the requirements and guidelines set
forth in the policy. Procedures should be implemented to ensure that eligible patients
receive discounts in accordance with the sliding fee scale.
Views of Responsible Officials and Planned Corrective Actions – The Organization concurs
with the finding and management has implemented procedures to ensure that eligible
patients receive discounts in accordance with the sliding fee scale. The Office Managers
will review all new sliding fee application on a monthly basis to ensure accuracy. The Billing
Manager will conduct quarterly audits of sliding fee claims to ensure the adjustments are
entered correctly by the billing department. The Organization has also launched additional training for
all individuals involved in the sliding fee application process as well as automated sliding fee
adjustments to reduce errors.