Finding 516917 (2023-002)

Significant Deficiency

Requirement

Questioned Costs

Year

2023

Accepted

2024-12-26

Audit: 334825

Organization: Centerplace Health, Inc. (FL)

Auditor: James Moore & CO P L

AI Summary

Core Issue: A patient was charged using the wrong sliding fee for a service, impacting billing accuracy.
Impacted Requirements: The Organization must keep accurate sliding fee applications and financial records to ensure proper patient charge adjustments.
Recommended Follow-Up: Enhance training and communication for finance staff to improve compliance with billing processes.

Finding Text

2023-02 - U.S. Department of Human Health and Services- Condition - The Organization placed one of its patients on a sliding fee for a different service than the one ultimately provided. Criteria - The Organization should maintain sliding fee applications and supporting finacial records for patients treated during the audit period to determine whether patient charges were appropriately adjusted. These patient charges are based on income and family size by applying the health center's sliding fee discount schedule according to the service that is provided. Cause - High turnover in the finance and accounting department as well as inadequate communication and training for the related processes at the Organization. Effect - The patient was charged on the correct sliding fee discount level, but for a lab visit instead of a medical visit. Recommendation - We recommend that the Organization continue to train and develop new personnel on specific processes related to compliance requirements.

Corrective Action Plan

Finding 2023-02 - U.S. Department of Human Health and Services- The Organization placed one of its patients on a sliding fee for a different service than the one ultimately provided. Since this occurrence, a new position has been created and staffed-- ‘Patient Service Representative Team Lead’. This staff member will oversee and train the Patient Service Representatives in their responsibilities, including the sliding fee discount schedule application and compliance. A focus of this newly created position is training and compliance of the sliding fee schedule throughout all the clinics, is ongoing since Oct. 15. The Patient Service Team Lead will be supervised by the Revenue Cycle Manager as part of the Finance Department reporting to the Interim CEO Anna Ferguson, who will oversee this effort. The new position and implementation of training to correct the finding commenced Oct. 15 2024.

Other Findings in this Audit

516918 2023-002

Significant Deficiency
516919 2023-002

Significant Deficiency
1093359 2023-002

Significant Deficiency
1093360 2023-002

Significant Deficiency
1093361 2023-002

Significant Deficiency

Programs in Audit

ALN	Program Name	Expenditures
93.224	Community Health Centers	$2.33M
93.527	Covid-19 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program	$95,965