Finding Text
Sliding Fee Discount: Federal Agency: U.S. Department of Health and Human Services; Award Name: Community Health Centers; Program Year: October 1, 2022 – September 30, 2023 Assistance Listing Number: 93.527/93.224; Criteria: The health center must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay. Condition: During compliance testing, it was identified that the sliding fee discount was not accurately applied to one patient out of a sample of 25. An additional patient did not have any support on file for the discount they received. Context: Some patients did not receive the proper discount based on the approved sliding fee schedule. Cause: The billing system utilized by the Organization does not automatically apply the discount, therefore requiring the Organization's billing team to review and manually adjust patient bills. Effect: As a result of the condition, some patients received incorrect bills. Recommendation: In the future, the Organization should work with the billing system vendor to automate the billing within the system. Additionally, the Organization should implement appropriate processes and controls to ensure a review is performed prior to sending patient bills. Views of Responsible Officials: Management acknowledges the finding and will work with the system vendor to correct the discount process.