Finding Text
Criteria: Health centers must obtain sliding fee applications so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay.
Condition: We tested 60 sliding fee encounters and noted that 40 out of 60 sliding fee encounters tested were discounted the incorrect amount. We further noted that the EMR system was not updated for the 2024 sliding fee schedule.
Cause and Effect: The Center failed to verify sliding fee discounts were applied correctly to charges and agreed to sliding fee rate schedules.
Recommendation: We recommend that sliding fee applications be completed for each sliding fee patient. Procedures should be implemented to verify applications are completed before the encounter is billed. Sliding fee discounts per policy should be agreed in the billing system to ensure the proper discounts are entered and updated. In addition, the Center could consider increasing its internal sampling throughout the year to verify sliding fee applications are obtained, completed, and agree to the discount applied.
Views of Responsible
Officials: Management agrees with the finding.
Corrective Action Plan: See attached correct plan.