Finding Text
Criteria: Patients that participate in the Sliding Fee program fill out an annual income determination form, which includes the patient's sliding fee discount determination. This determination is based on annual income and family size. The annual income determination form is reviewed and approved by supervisors or management. Additionally, each patient claim is reviewed and approved to confirm the proper application of the patient's sliding fee discount. Condition: During our testing of patients participating in the Sliding Fee program, we noted two instances where the sliding fee discount was incorrectly applied. Cause: This was an oversight by management and supervisors of the Sliding Fee program because of turnover within the Organization. Effect: Patients participating in the Sliding Fee program could be charged an incorrect fee based on the wrong sliding fee discount. Repeat Finding: N/A Recommendation: The Organization should implement procedures to ensure that each patient participating in the Sliding Fee program is being charged the correct sliding fee discount based on their annual income and family size. Response: Management will strengthen procedures over the Sliding Fee Discount Program to ensure each patient's discount is accurately determined based on documented annual income and family size and correctly applied to patient charges. Procedures will include documented supervisory review of income determinations and verification that the approved sliding-fee discount is accurately reflected in the patient billing process. Management will also provide appropriate staff training and incorporate periodic monitoring to identify and correct discrepancies timely.