Finding 1165916 (2025-002)

Recommendation: Management should consider increasing the frequency of its self-reviews of sliding fee encounters, increasing the frequency of when patient portal updates are being reviewed and approved, and/or provide additional training for front desk staff regarding the collection and verification of patient information for each patient. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action planned/taken in response to finding: See matrix below Name(s) of the contact person(s) responsible for corrective action: Hiren Patel, CFO Planned completion date for corrective action plan: See matrix below Finding 2025-002 / ACTION STEP 1 / ACTION STEP 2 / ACTION STEP 3 / ACTION STEP 4 Assigned / RCM Leaders / Executive Leaders / Patient Care Reps (PCRs) / Practice Managers / Enrollment Specialist/RCM Leaders Resources needed / Annual Federal Poverty Level (FPL) update issued no later than February of each year, given by federal government / Supporting financial documentation for all patients/applications / Athena (EHR system) / Audit tracking tools, EHR reports Actions to be taken / Audit EHR system to ensure timely update by EHR each year; updated internal QRG and distribute to Operations front-staff leaders and Compliance Update patient level amounts based on approval by Executive Leaders- as needed / Complete review of supporting financial documentation for each patient/application Upload documentation in EHR to support approval/disapproval-update EHR accordingly 85% collections of patient levels at time of service / Practice Manager Audits 25 SFS claims to ensure all documentation has been received, uploaded and reviewed accurately / Enrollment Specialist reviews patient account during self-pay collection efforts for all that have outstanding balances; ensures all have supporting documents aligning with approval, notifies RCM leaders monthly of inaccurate findings RCM Leaders audit 50-60 accounts quarterly to cover all sites Progress indicated at benchmark / Implement workflow / Implement workflow / Implement **NEW**Workflow / Implement workflow Completion date / February of each year / February 2026 / February 2026 / February 2026 Evidences of improvement / Reporting to ensure alignment / Monthly audit / Monthly audit / Monthly/Quarterly audit