GASTON FAMILY HEALTH SERVICES, INC.

Finding 2022-002 Special Tests and Provisions Criteria: Sliding fee rates are calculated correctly and applied to qualifying patients. Condition: Two out of 60 tested of medical patient charges did not apply the sliding fee scale to the calculation correctly. Two out of 15 tested of dental patients did not apply the sliding fee scale to the calculation correctly. Effect: Accounts receivable for patients could be inaccurately stated. Cause: The staff did not select the charge as subject to reduction or selected the wrong percentage to be applied. Recommendation: Management should ensure that account receivable clerical staff receive training on recording sliding fee adjustment in patient account and record reduction after patient visit or when patient brings in sliding fee qualification documentation and staff or a manager run a monthly report for sliding fee patients and review a…

Corrective action: Gaston Family Health Services takes application of the sliding fee scale very seriously. To help ensure that the sliding fee schedule is being applied correctly, each practice will undergo further training on the application of the Sliding Fee Scale once a year, in addition to thorough training upon hiring staff. Also, each practice manager will run a monthly report for sliding fee patients and review accounts to ensure sliding fee reduction have been properly recorded to patient accounts.

Federal Program Identification: U.S. Department of Health and Human Services Community Health Center ? CFDA 93.224 Finding 2021-001 Special Tests and Provisions Criteria: Sliding fee rates are calculated correctly and applied to qualifying patients. Condition: Two out of 60 tested of patient charges did not apply the sliding fee scale to the calculation correctly. Effect: Accounts receivable for patients was overstated. Cause: The staff did not select the charge as subject to deduction. Recommendation: We recommend the account receivable clerical staff receive training on recording sliding fee adjustment in patient account and record reduction after patient visit or when patient brings in sliding fee qualification documentation and staff or a manager run a monthly report for sliding fee patients and review accounts to ensure sliding fee reductions have been properly recorded to…

Corrective action: Management Response: Gaston Family Health Services takes application of the sliding fee scale very seriously. To help ensure that the sliding fee schedule is being applied correctly, GFHS has taken additional measures to improve the accuracy and consistency of application of the Sliding Fee Scale Policy. In May of 2022, Gaston Family Health Services has hired a new Revenue Cycle Director with over 25 year of experience to help guide and direct the overall revenue cycle process, including proper application of the Sliding Fee Scale Policy. Additionally, Gaston Family Health Services will have each practice managers select a sample of at least 10 self-pay patients from their schedule each …

Criteria: Sliding fee rates are calculated correctly and applied to qualifying patients. Condition: One instance out of 60 tested of patient charges were not properly reduced for sliding fee. Effect: Accounts receivable for patients was overstated. Cause: The staff did not select the charge as subject to deduction. Recommendation: We recommend the account receivable clerical staff receive training on recording sliding fee adjustment in patient account and record reduction after patient visit or when patient brings in sliding fee qualification documentation and staff or a manager run a monthly report for sliding fee patients and review accounts to ensure sliding fee reductions have been properly recorded to patient accounts. Views of Responsible Officials and Planned Corrective Actions: Management of the Organization agrees with finding and will adhere to the Corrective Action Pla…

Corrective action: Management Response: Gaston Family Health Services takes application of the sliding fee scale very seriously. To help ensure that the sliding fee schedule is being applied correctly, GFHS will have each practice managers select a sample of at least 10 self-pay patients from their schedule each month and audit the application of the sliding fee scale to the patients account for accuracy and completeness. If errors are found, the sample size will be enlarged until there is confidence the sliding fee schedule is being completed accurately. The audits will be submitted to the Business Office Supervisor each month for review to ensure this is being done timely. Responsible Party Contacts: …