Finding 404737 (2023-005)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2023
Accepted
2024-06-29

AI Summary

  • Answer: Management is actively promoting communication with the granting agency.
  • Trend: This approach aims to ensure that reimbursement rates are consistently verified for accuracy.
  • List: Follow up by documenting communication efforts and confirming rate accuracy with the agency.

Finding Text

Recommendation: Management is and will encourage communication with the granting agency to confirm that all rates used for reimbursement are accurate.

Corrective Action Plan

Valle del Sol, Inc. is in the process of ensuring the proper reimbursement rates for the Mercy Care program will be utilized to invoice accurately. Val del Sol, Inc. will discuss with Mercy Care obtaining the most current formal fee schedule instead of a listing of allowable CPT codes. We will also implement a training for all front and back office staff to include a better understanding of the Mercy Care City program. Scripts for frequently asked questions from patients, and worksheets for staff to complete to ensure all required documents are received, will be available to staff to ensure proper application of eligibility of the Mercy Care program.

Categories

Cash Management

Other Findings in this Audit

  • 404735 2023-003
    Significant Deficiency Repeat
  • 404736 2023-004
    Significant Deficiency
  • 981177 2023-003
    Significant Deficiency Repeat
  • 981178 2023-004
    Significant Deficiency
  • 981179 2023-005
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.829 Section 223 Demonstration Programs to Improve Community Mental Health Services $1.02M
21.027 Coronavirus State and Local Fiscal Recovery Funds $754,576
93.958 Block Grants for Community Mental Health Services $716,069
93.665 Emergency Grants to Address Mental and Substance Use Disorders During Covid-19 $417,470
93.959 Block Grants for Prevention and Treatment of Substance Abuse $399,286
93.788 Opioid Str $321,580
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $281,719
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $201,315
93.498 Provider Relief Fund $120,787
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $25,000
93.185 Immunization Research, Demonstration, Public Information and Education_training and Clinical Skills Improvement Projects $5,000