WILLIAM F. RYAN COMMUNITY HEALTH CENTER, INC

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 Ryan Health’s policy and the patient documentation provided, noting instances where the adjustments to charges were inconsistent with Ryan Health’s SFDS. Cause - Lack of controls to ensure that staff are obtaining required documentation and entering the information correctly. Effect - Out of our sample of 20 selections, we identified eleven exceptions based on the SFDS. Seven of the discounts entered lacked the required slide documentation, the slide form had expired and was not updated, or the …

Corrective action: Management response - Verification of income and assignment of sliding fee categories are the responsibility of the Patient Services staff. Over the last few years, we have experienced significant turnover in that area. In addition, we have implemented electronic registration, both onsite (through the use of kiosks) and offsite (using the Luma remote registration and communication platform). As a result, a significant cohort of patients conducts a self-registration. This requires new workflows to ensure correct assessment and documentation. Ryan Health has implemented an extensive training program for "front desk" staff and supervisors under the leadership of the new Chief Operating Officer …