Finding Text
Criteria: Health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay.
Condition: While we were eventually able to obtain a complete and accurate population of the eligible patients that received the sliding fee discount for the year ended September 30, 2022, it took multiple attempts before the Organization was able to provide us with that population. Prior to receiving the accurate listing, we received multiple files that either included patients that received the sliding fee discount outside of the audit period or included ineligible patients.
Cause: The sliding fee discount schedule is the responsibility of the Revenue Cycle Manager. There was turnover in this role and the current Revenue Cycle Manager was not employed during the audit period.
Effect: There were delays in completing the testing.
Recommendation: The Organization should implement procedures to ensure that a complete and accurate population of the eligible patients that received the sliding fee discount is maintained and readily available upon request.
Response: The Organization has hired an Executive Director of Revenue Cycle to manage all aspects of revenue cycle (including the Sliding Fee Discount Program). The Director has created a Standard Operating Procedure (SOP) for each EHR system to ensure that all staff administering sliding fee discounts understand the sliding fee process. Additionally, the newly hired Director will implement a training program for all staff involved in the preparation and application of the sliding fee discount schedule.