Finding 501228 (2024-001)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2024
Accepted
2024-10-01
Audit: 323494
Organization: Pureview Health Center (MT)
Auditor: Kcoe Isom LLP

AI Summary

  • Five errors were found in applying the sliding fee scale during the audit, affecting patient billing.
  • Improper application of the sliding fee scale could lead to loss of funding and inequitable access to healthcare services.
  • We recommend strengthening internal controls by reviewing claims to ensure the sliding fee scale is applied correctly.

Finding Text

Condition: As a result of our audit procedures, we found five errors in the application of the sliding fee scale. Criteria: The sliding fee scale discount is based on patient income and demographic information. Controls should be in place to ensure the sliding fee scale is consistently applied for each patient. Effect: Continued noncompliance could result in a loss of funding. Additionally, it could result in inequitable access to healthcare services for patients and expose the Center to reputational risks. Context: During our testing, we found 5 of the 60 patients tested were not billed for the proper slide category based on the sliding fee scale provided by the PureView. No questioned costs were identified. Cause: The errors resulted from claims where the sliding scale was improperly recorded within the claim. There was no check to verify that the claim scale matched the scale within the patient files. These claims were missed during the billing department’s internal review of scale application. Individuals responsible for the primary and secondary review of sliding fee scale applications requires additional training and resources to ensure errors are detected timely. Recommendation: We recommend that PureView strengthen its internal controls by reviewing claims to ensure proper application of the sliding fee scale. Management Response: See Corrective Action Plan.

Categories

Internal Control / Segregation of Duties

Other Findings in this Audit

  • 501227 2024-001
    Significant Deficiency
  • 1077669 2024-001
    Significant Deficiency
  • 1077670 2024-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $2.10M
93.224 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $674,367