2022-001, 2021-001 - MATERIAL WEAKNESS AND MATERIAL NONCOMPLIANCE - SLIDING FEE - Contact Person - Patricia Fournier, CFO Completion Date - 11/01/2022. Finding ? We tested 60 sliding fee encounters and noted that 3 of 60 sliding fee encounters tested did not have sliding fee applications, 13 out of 60 patients were discounted the wrong amount, 2 out of 60 patients sliding fee applications could not be located. We recommend the Organization continue with the corrective action plan implemented in the prior year in response to audit finding 2021-001 to ensure sliding fee applications are completed before encounters are billed. We recommend that management continue to review and monitor the internal sliding fee application auditing process for further improvements and consider increasing sample sizes. Response and Resolution: RESOLUTION: 1. Staff Training. The onset of COVID, staff turnover, and the abrupt implementation of Telehealthcaused some gaps in the adherence of processes such as sliding fee application updates. Honordeveloped and implemented an in-depth monthly training for front-end processes. The trainingincludes patient check-in, insurance verification, and sliding fee application completion. Participantscomplete a test to ensure the necessary knowledge and skills were obtained during the training. If theparticipant?s score is under our benchmark, they will complete the training again. This training isrequired for all front-end staff and practice managers. Staff will complete the training as part of newemployee on-boarding. Staff will also be required to complete an annual update training. 2. Dashboard Reporting & Sample Testing. A need for more immediate accountability was determinedin review of the clinic site infrastructure. Honor developed and implemented a daily dashboard to beused by the Practice Manager to monitor prior day visits to ensure that all patient check-in, insuranceverification, and sliding fee applications information is input correctly. In addition, the dailydashboards are audited by our Risk Management team weekly and the number of reviews will beincreased to 25% of the total weekly charts. These audits include verifying the sliding fee applicationis completed correctly with a signature, the slide was input correctly in the EHR, and a proof of incomeis attached. These weekly audits are accumulated monthly and reported to management for review.A new workflow process will be developed to ensure that appropriate on-site staff view the slideinformation in the EHR to ensure it matches the sliding fee application and proof of income. 3. Review Current Policy and Application ? Honor will review the current sliding fee application and policy. The review will include a patient survey to determine if our application is appropriate for our patient population to complete. Honor will also determine if requiring proof of income is a barrier to care for our patients. Management will explore all Federal, State and local regulations and guidelines to ensure our policy stays within these regulations.