Finding 484795 (2023-001)

Finding – Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) (ALN 93.224) and Grants for New and Expanded Services under the Health Center Program (ALN 93.527) Criteria: Family Health Network of Central New York, Inc. is required to have a sliding fee scale policy and to provide discounts to patients based on the established policy. Condition: During our audit, we tested a sample of 25 sliding fee scale calculations. Three patients in our sample were charged the incorrect amount based on the sliding fee determination. The sliding fee scale calculation used the incorrect slide discount percentage. Context: We reviewed 25 patient’s files for documentation of sliding fee scale calculations. Cause: Inconsistent application of sliding fee scale calculations with change in billing software during the year. Effect: Family Health Network of Central New York, Inc. is not following its established policy. Recommendation: We recommend that Family Health Network of Central New York, Inc. provide training to those making eligibility calculations and implementation in the new billing software.