Finding Text
Grant Program: Department of Health and Human Services Health Centers Cluster – Assistance Listing # 93.224/93.527
Condition: As a result of our audit procedures, we noted instances where no supporting eligibility application and income verification were maintained by Community Health Partners, Inc. (the Clinic) to support the sliding fee scale discount adjustment that the patient received.
Criteria: The sliding fee scale discount is based on patient income and demographic information.
Effect: Continued non-compliance could result in a loss of funding. Additionally, it could result in improper client billing and loss of revenue.
Context: The Clinic did not maintain an eligibility application and income verification for 3 out of 40 patients tested.
Cause: The Clinic had no form of secondary review in place, resulting in the errors in improper documentation not being detected and corrected in a timely manner.
Recommendation: We recommend a secondary review of the applications and system input to ensure the proper documentation is verified in the electronic health records to support the slide eligibility.
Management response: See Corrective Action Plan.