Finding 986299 (2022-001)

- Repeat Finding
Requirement
E
Questioned Costs
-
Year
2022
Accepted
2023-07-23
Audit: 311951
Organization: Goshen Medical Center, Inc. (NC)

AI Summary

  • Core Issue: 3 errors were found in income calculations across 75 applications at 3 locations, affecting patient billing.
  • Impacted Requirements: GMC must ensure accurate billing for federally supplemented services; inconsistent procedures led to calculation errors.
  • Recommended Follow-Up: Implement a review process for recalculating fees by site leaders and provide ongoing training for front desk staff on the sliding fee scale.

Finding Text

Criteria: 75 applications at 3 locations were tested. 3 errors were found. The table summarizes the findings. Issue: Incorrect calculations of income, fees charged would not change, 2 errors. Incorrect calculations of income, fees charged would change, 1 error. Condition: GMC has the responsibility of ensuring proper billing of patients for services that are supplemented by the federal government. Effect: The findings had various effects depending on the issue noted above. In most instances where fees would change, more income would be due to GMC from patients. Cause: Application calculations were not checked by another employee. Procedures and standards were inconsistently followed. Recommendation: The review process of the sliding fee scale application should include a recalculation by the site leader. Front desk employees should receive continuing education classes on the proper way to calculate the sliding fee scale. Management response: Management concurs with the finding and has proposed corrective action.

Categories

No categories assigned yet.

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $14.15M
10.766 Community Facilities Loans and Grants $971,353
93.498 Provider Relief Fund $783,720
93.968 Immunization Cooperative Agreements $417,188
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $19,370
93.247 Advanced Nursing Education Grant Program $771