Finding 42279 (2022-001)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2022-12-07
Audit: 45668
Organization: Community Treatment, Inc. (MO)

AI Summary

  • Core Issue: One patient's sliding scale category was incorrectly entered, leading to inaccurate billing.
  • Impacted Requirements: Compliance with the sliding fee discount schedule as mandated by the Office of Management and Budget.
  • Recommended Follow-Up: Enhance training and review processes for accurate data entry and implement regular audits to prevent future errors.

Finding Text

Federal Program: Assistance Listing 93.224 Health Center Program Cluster: Consolidated Health Center Compliance Requirement: Special Tests and Provisions Condition: One patient?s sliding scale category was not correctly input into the billing system. Criteria: The Office of Management and Budget Compliance Supplement requires that health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Questioned Costs: Unknown Context: In a sample of 40 sliding scale patients, one patient?s sliding scale category was incorrectly entered into the system. Effect: One application was not entered correctly into the system, resulting in an incorrect amount being billed to the patient. Cause: Adequate procedures were not in place to ensure that required administrative responsibilities, including ensuring that patient eligibility determinations were correctly entered into the system, were being performed and reviewed for accuracy. Recommendation: We recommend Comtrea revisit their processes and procedures regarding the sliding scale process focusing on adequate education and review to ensure timely and accurate conclusions, input, reporting, and billing. Management's Response: Community Treatment, Inc has in place a policy regarding sliding fee discount program that includes review and random audits of individual sliding fee applications. The error found during the course of the financial audit was the result of incorrect data entry into the EMR for the specific patient. The application itself was correct. Corrective action to reduce the risk of this happening in the future includes, training to all staff of the policy and procedures and the importance of accurate data entry. Additional audit steps will include verification of the data entered and actual calculation on the patient ledger. The audit sample selected by the billing department will be increased for each clinic location and additional reporting of any findings to the appropriate management staff will be shared on a weekly basis.

Corrective Action Plan

November 2022 PLANNED CORRECTIVE ACTION FOR CURRENT YEAR FINDINGS FINANCIAL STATEMENT FINDING There were no financial statement findings. FEDERAL AWARD FINDING OR QUESTIONNED COSTS For the year ended June 30, 2022, there was one federal award finding as summarized below. Finding 2022-001: The Office of Management and Budget Compliance Supplement requires that health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. In a sample of 40 sliding scale patients, one patient?s sliding scale category was incorrectly entered into the system. Views of Responsible Officials and Corrective Action Plan: Community Treatment, Inc has in place a policy regarding sliding fee discount program that includes review and random audits of individual sliding fee applications. The error found during the course of the financial audit was the result of incorrect data entry into the EMR for the specific patient. The application itself was correct. Corrective action to reduce the risk of this happening in the future includes, training to all staff of the policy and procedures and the importance of accurate data entry. Additional audit steps will include verification of the data entered and actual calculation on the patient ledger. The audit sample selected by the billing department will be increased for each clinic location and additional reporting of any findings to the appropriate management staff will be shared on a weekly basis. Contact: Amy Rhodes Anticipated Completion Date: December 2022

Categories

Special Tests & Provisions Eligibility Reporting

Other Findings in this Audit

  • 618721 2022-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $2.51M
93.498 Provider Relief Fund $336,645
14.267 Continuum of Care Program $176,938
93.788 Opioid Str $95,590
93.959 Block Grants for Prevention and Treatment of Substance Abuse $88,304
93.958 Block Grants for Community Mental Health Services $50,000
93.665 Emergency Grants to Address Mental and Substance Use Disorders During Covid-19 $20,735
16.576 Crime Victim Compensation $15,676
16.575 Crime Victim Assistance $14,435
93.982 Mental Health Disaster Assistance and Emergency Mental Health $8,212