October 5, 2023
To: United States Department of Health and Human Services
Generations Family Health Center, Inc. respectfully submits the following corrective action plan for the year ended June 30, 2023.
CohnReznick LLP
350 Church Street
Hartford, CT 06103
Audit Period: June 30, 2023
The findings from the June 30, 2023 schedule of findings and questioned costs are discussed below. The finding is numbered consistently with the numbers assigned in the schedule.
FINANCIAL STATEMENT FINDINGS:
Finding 2023.001- Sliding Fee Scale Documentation
Recommendation
The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income.
Action Taken: Upon review of the finding, it was determined that the system calculated the slide correctly, but the procedure code was assigned to the incorrect procedure class, creating the error.
Beginning July 1, 2023, Management has:
• Reviewed the entire fee schedule, schedule of discounts and procedure groupings in the practice management system compared to the board approved fee schedule. Only one procedure group required correction of one procedure code.
• In addition, the Director of Patient Revenue will work with the Electronic Health Record vendor to organize the system procedure classes for all procedure codes and financial classes to decrease any crosswalk issues or redundancies. In addition, the Director of
Patient Revenue will work with the EHR vendor to upload fee schedules and sliding fee
discount groups electronically.
Previous internal controls adopted include:
• Upon creating adding a new charge to the system, the Director of Patient Revenue posts
the charge into a test patient account to confirm that the standard and slide rates match
those entered on the fee schedule
• At the annual review and/or revision of the Agency’s fee schedule, the Billing Manager
assists the Director of Patient Revenue in reviewing every charge on the
updated/approved year’s fee schedule to confirm the rates and slide assignment match
the Fee Schedule.
• A quarterly audit of insured and self-pay patients occur to review that adjustments are
correct per agency policy. This action decreases chances of system issues that cause
erroneous adjustments going unnoticed.
If the Cognizant or Oversight Agency for Audit has questions regarding this plan, please
call: Debra Savoie, CFO at (860) 456-6271.