2025-001 Special Tests and Provisions - Sliding Fee Scale Discounts
Recommendation: To help ensure that sliding fee scale (SFS) discounts are properly calculated and documented, the Center should perform random reviews of its SFS applications to detect and correct errors or incomplete applications on a timely basis.
Corrective Action Taken:
1. Immediate Review and Correction
Upon determination of the finding, we conducted a full review of the affected patient account.
2. Staff Training
All Outreach and Eligibility staff have received refresher training on the proper application of the sl iding fee scale, including income verification processes and documentation standards. This training now occurs as part of onboarding and annually thereafter.
3. Policy and Procedure Review
We reviewed our internal policies and procedures to ensure clear guidance on income documentation requirements, allowable income sources, and how to properly apply the sliding scale.
4. Double-Verification Process
A second-level review has been instituted for all new patient applications and renewals involving sliding fee scale determinations. This ensures that income is correctly assessed, and the appropriate fee level is applied before any charges are finalized.
5. Audit and Monitoring
A quarterly internal audit process has been implemented to review a random sample of sliding fee scale determinations for accuracy. Findings from these audits will be tracked, and any trends will be addressed through targeted training or process changes. Ongoing Commitment:
We are committed to continuous improvement and will monitor the effectiveness of these corrective actions over the next year. Adjustments will be made as necessary to ensure sustained compliance and fairness in our billing practices. Our goal is to uphold transparency and affordability in patient care while maintaining full adherence to regulatory standards.
Contact Person: Tamie Olson, Chief Financial Officer
Completion Date: Fiscal year ending January 31, 2026