Finding 1161153 (2023-002)

Criteria: The health center must prepare and apply a sliding fee discount schedule so that the amounts owed for heath center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay based on specific guidelines. Condition: There were 4 instances in our sample of 62 where the proof of income documentation did not support the sliding fee discount adjustment. In 3 of those 4 instances, 100 percent of the fee was written off without any support for the adjustment. In addition, x-ray services are a flat $50 charge regardless of the patient’s ability to pay. The Organization’s sliding fee scale policy should be updated to reflect that policy for x-ray services. Cause: Policies and procedures were not established to ensure that the appropriate sliding fee discount adjustment was taken for all eligible transactions. Effect: Patients could have been improperly charged for services provided. Recommendation: Appropriate policies and procedures should be established to ensure that all sliding fee discounts taken follow the Organization’s sliding fee scale policy. The policy for x-ray service charges should be updated to reflect current practice.