Finding Text
Criteria Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition and Context During our testing of 40 sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Questioned Costs None noted. Effect Potential that a patient would not receive the appropriate sliding fee discount. Cause Clerical error resulted in incorrect sliding fee discount. Recommendation We recommend the Organization take measures to ensure that appropriate sliding fee rates/categories are used for each sliding fee encounter. Views of Responsible Officials and Planned Corrective Actions The Organization agrees with the finding of one visit receiving an incorrect sliding fee discount. The application process for determining the correct sliding fee discount is layered in human interventions resulting in multiple areas an error could occur. The Outreach and Enrollment Department, who handles the sliding fee application process, will continue to receive training on the processes and the reason why for correctly completing and entering the sliding fee application within the Electronic Health Record. An internal audit will continue to monitor the discount received matches the sliding fee application.