Finding Text
Criteria - Health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. The health center must demonstrate adjustments to charges are consistent with the health center’s SFDS. Condition - We attempted to recalculate the applied discount using Metro Community Health Centers, Inc.’s policy and the patient documentation provided, noting instances where the adjustments to charges were inconsistent with Metro Community Health Centers, Inc.’s SFDS. Cause – SFDS discounts were inconsistently applied to services provided to individuals who attested to their eligibility. Effect - Out of our sample of 25 selections, we identified eight exceptions based on the SFDS. Recommendation - We recommend evaluating the current process and either changing it to match what is being done or provide education those involved in the process to adhere to Metro Community Health Centers, Inc.’s existing written policies and procedures in this area. We also encourage Metro Community Health Centers, Inc.’ to consider assigning a dedicated individual to regularly review the sliding fee visits to ensure compliance. This should be someone who is knowledgeable of the sliding fee requirements and Metro Community Health Centers, Inc.’s billing processes and procedures. View of Responsible Official – Metro Community Health Centers agrees that the sliding fee process needs to be revised and will implement procedures to match workflow. Additionally, Metro Community Health Centers will retrain all staff and assign a dedicated individual to perform monthly reviews.