Finding 22441 (2022-001)

2022-001: Significant Deficiency in Internal Control and Noncompliance with Special Tests and Provisions in Application of Organization's Sliding Fee Discounts Policy - Criteria: Health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. - Condition: During the year the control that was designed failed to ensure proper application slide adjustments to patient accounts, which resulted in over application of discounts to patient accounts. - Cause: There was significant turnover during the year where individuals processing the adjustments may not have understand the policy and didn't properly apply it to the patient. - Effect or potential effect: The Organization was not in compliance with special tests and provisions during the year and excess adjustments of patient balances over the adopted policy could result in financial losses to the Organization. - Questioned Costs: N/A - Context: During the auditor's review of the SFDS and the application utilized by the Organization as a part of their process in determining and documenting the discounts applicable. The audit reviewed the application to 25 patient accounts in which it was noted that there were three instances where the determination that an individual after application of the discount to the account should be required to pay a nominal fee per the Organization's policy but instead the full charge was written off. - Identification of Repeat Finding; N/A - Recommendation: We recommend the Organization ensure that the staff processing the slide adjustments understand the policy and the system application to patient accounts to ensure accuracy. Additionally improve the application and processing procedures to ensure that slide adjustments was properly applied to the patient accounts and documentation is retained. - View of Responsible Officials: See Corrective Action Plan.