Finding 1154128 (2024-001)

Finding 2024-001 – Material Adjustments We acknowledge the finding and agree that the lack of timely reconciliations and reliance on audit adjustments indicated a breakdown in internal controls over financial reporting. Cause and Context: The root cause of this issue was primarily driven by the time spent unwinding the billing from the operational team and setting them up under the new Revenue Cyle Director position in the finance department. This department will now be directly responsible for the various Medicaid AR processes. Most of the material audit adjustments were the direct result of not having this group under the Finance department so proper determination could be made on the collection of these services. Corrective Actions Taken and Planned: 1. Moving all billing functions to the finance team: This team will be able to make quarterly adjustments to the Medicaid billing receivables. 2. Third party vendors: The finance team has established routine calls with our third-party billing partners to determine collectability throughout the year vs during the audit period. 3. Training and Oversight: The billing team has now created a weekly meeting / training cadence. 4. Revenue Cycle Management Enhancements: We have established an internal Billing and Revenue Cycle Management Team and developed a Centralized Intake Team to improve billing accuracy, eligibility verification, and reduce reliance on third-party vendors. These changes are expected to reduce write-offs and improve the integrity of our receivables. We are confident that these corrective actions will address the root causes of the finding and prevent recurrence. Management remains committed to maintaining strong internal controls and ensuring compliance with all applicable accounting standards. 5. In-House Billing for Specialized Services: Billing for Developmental Disabilities (DD) and Intermediate Care Facility (ICF) services have been brought in-house. This transition has resulted in a 14% increase in DD revenue and improved responsiveness to denials, client liability tracking, and continued stay approvals. These enhancements are designed to improve financial accuracy, reduce write-offs, and ensure timely and compliant revenue recognition. We are confident that these measures will prevent recurrence and strengthen the integrity of our financial reporting going forward.