Finding Text
Criteria: Health Centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted or discounted based on the patient's ability to pay. Condition: Some patients did not receive the proper sliding fee discount. Cause: Errors within the setup of the Center's billing software and front desk turnover. Questioned Costs: Known or likely questioned costs are less than $25,000. Context: Of the 60 patients sampled, 13 patients did not receive the proper adjustment or discount. Effect: Improper adjustments or discounts could lead to inaccurate financial statements as well as improper patient billings. Auditor's Recommendation: Management should have procedures in place ensureing that each eligible patient receives the proper discount or adjustment based on their ability to pay. Management's Response: The Center agrees with the finding. While additional training and corrections to the practice management system were completed in the prior fiscal year, turnover and additional system issues still plague the process. The Center has developed an improved front desk audit tool in response to this finding which includes verifying certain sliding fee components with an updated methodology increasing the number in the sample per month. The new front desk audit tool will be tested by February 28, 2024 and continue monthly with changes suggested during the test as needed throughout the next 12 months.