Finding 1174198 (2025-001)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2025
Accepted
2026-02-18

AI Summary

  • Answer: Two sliding fee discounts were calculated incorrectly, and five charge rates in the Practice Management System were also wrong.
  • Trend: Errors were found in a small sample of transactions, but the overall impact on the program is considered immaterial.
  • List: Follow up by reviewing the calculation process for sliding fee discounts and charge rates to prevent future errors.

Finding Text

During our compliance testing of sliding fee discounts for the Organization, there were two instances in which the sliding fee discounts were calculated incorrectly. During our testing of revenue transactions, five instances of incorrect charge rates in the Practice Management System were identified. We note that the compliance finding was immaterial to the program overall. A random sample of sixty-five encounters was reviewed, including forty sliding fee encounters selected for compliance testing. Two of the forty sliding fee selections were incorrectly calculated. Five of the twenty-five remaining selections resulted in incorrect charge rates in the Practice Management System.

Corrective Action Plan

The Sliding fee determination will be reviewed by the front desk staff thoughtfully daily to ensure the proper charge to the patient. We have redeveloped our front office patient registration flow. Once the patient is screened and determined to be eligible for the Sliding Fee program by the front office/enrollment department, the patient will complete the Sliding Fee application and Self‑Declaration of Income and Family Size. The front office/enrollment department verifies/signs the application, determines what scale the patient qualifies for, and verifies with our practice management system. The Front Office/enrollment department will upload documents into the patient's chart in eCW and contact the billing department at extension 1907. The Lead Biller will review all uploaded documents and approve the Sliding Fee in real time. All Sliding Fee applications must be reviewed by billing before the patient leaves the clinic.

Categories

No categories assigned yet.

Programs in Audit

ALN Program Name Expenditures
93.224 HEALTH CENTER PROGRAM (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, AND PUBLIC HOUSING PRIMARY CARE) $2.12M
93.243 SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES PROJECTS OF REGIONAL AND NATIONAL SIGNIFICANCE $677,788
93.526 GRANTS FOR CAPITAL DEVELOPMENT IN HEALTH CENTERS $580,462
93.527 GRANTS FOR NEW AND EXPANDED SERVICES UNDER THE HEALTH CENTER PROGRAM $562,773
93.939 HIV PREVENTION ACTIVITIES NON-GOVERNMENTAL ORGANIZATION BASED $441,624
93.217 FAMILY PLANNING SERVICES $105,300
93.493 CONGRESSIONAL DIRECTIVES $94,456
93.918 GRANTS TO PROVIDE OUTPATIENT EARLY INTERVENTION SERVICES WITH RESPECT TO HIV DISEASE $17,185