Finding Text
2024‐002 – Department of Health and Human Services Health Centers Cluster – CFDA# 93.224
Criteria: Controls should be in place to ensure the sliding fee scale is consistently applied for each patient.
Condition: As a result of our audit procedures, we found multiple errors in the sliding fee categories
patients were put into based on information retained in the Athena Billing System.
Context: During our testing, we found 2 of the 15 patients tested were not in the proper slide category
based on the income backup received for the patient.
Effect: The result of including patients in the wrong category could be either over or under billing to the
patient.
Cause: The cause is due to errors in calculating and entering the patient’s income into the software and
ensuring the software put the patient in the correct category.
Recommendation: We recommend all applications have support attached for income verification and are
reviewed and approved by someone other than the person gathering the information to ensure they are
in the proper category and also verifying the software has assigned the proper category.
Auditee Response and Corrective Action Plan: Management agrees with this finding. OVH recognizes and
values the importance of the sliding fee program as integral to our mission as a federally‐qualified
community health center. We intend to take the necessary steps to ensure full compliance with the
provisions of the program, identified specifically as Sliding Fee Discount Program (SFDP) within our
organization. These steps include:
Auditee Response and Corrective Action Plan:
a) Implementing a new process for adding the sliding fee discount to patient accounts. Each
patient that applies for the slide will be scheduled under “eligibility” with an appointment. After
the patient has completed the application, the information will be entered into Athena, and then
the plan will be calculated. The paperwork will then be uploaded as an attachment to the Sliding
Fee Discount Policy. Each week, a report will be generated in Athena and sent to the Clinical
Services Manager. This report will list all patients that had an appointment with eligibility for the
prior week. The Clinical Services Manager will then use that report and verify that all information
is uploaded and entered correctly.
b) Training on the new process will occur. All support staff responsible for entering and uploading
the Sliding Fee Discount will go through thorough training of the new process. Additionally, the
Clinical Services Manager will complete peer‐to‐peer training on the verification process.