Finding Text
Finding 2022-001Federal program and specific federal awardU.S. Department of Health and Human Services (HHS)93.224/93.527 Consolidated Health Centers (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, Public Housing Primary Care, and School Based Health Centers); (HHS Community Health Center Program)Specific requirementHealth 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.ConditionDuring a sample of 25 patient visit encounters, we noted that 1 patient visit from March 2022 did not have the applicable sliding fee application on file and the patient charge was adjusted down to zero.CauseThis was due to an error made by manual entry to adjust the sliding fee without sufficient support on file of the patient?s sliding fee application.Effect or potential effectA patient received a sliding fee to write off the entire charge of $210 that was not supported by a sliding fee application. Subsequent to the discovery of the error during the audit, in April 2023, the Organization was able to obtain an application from the patient to support a sliding fee to a charge of $70.Questioned costsNoneRepeat findingNoRecommendationWe recommend that management continue to work and educate front desk and intake staff on the importance of the required patient application documentation so that the required support is obtained before applying a sliding fee discount to a patient account. In addition, we suggest that management establish a policy to perform regular monitoring of a sample of patient file sliding fee applications, to ensure the sliding fee is applied correctly.Management responseWe agreed with the above comment and will implement a system of monitoring sliding fee applications and continue to educate the front desk and intake staff to ensure all documentation is obtained