SALUD FAMILY HEALTH, INC.

Criteria Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition and Context During our testing of 40 sliding fee discounts for health center patients qualifying for reduced charge visits, we identified two visits that received the incorrect sliding fee discount and one visit where the sliding fee application was not able to be found. Questioned Costs None noted. Effect Potential that a patient would not receive the appropriate sliding fee discount. Cause Clerical error resulted in incorrect sliding fee discount. Recommendation We r…

Corrective action: Recommendation: Out auditors recommended the Corporation take measures to ensure that appropriate sliding fee rates/categories are used for each sliding fee encounter. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Corporation utilizes an external billing company. The external billing company has implemented an automated revision using robotics to ensure that sliding fee adjustments are made accurately according to the patients' sliding fee scale. Also, as required by HRSA, the Corporation records household income in our EMR for both sliding fee and non-sliding fee patients. Enrollment specialists proc…

Criteria Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition and Context During our testing of 40 sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Questioned Costs None noted. Effect Potential that a patient would not receive the appropriate sliding fee discount. Cause Clerical error resulted in overcharging the patient. Repeat Finding Not a repeat finding. Recommendation We recommend the Corporation take measures t…

Corrective action: Consolidated Health Centers Grant - Assistance Listing No. 93.224 and 93.527. Recommendation: Our auditors recommended the Corporation take measures to ensure that appropriate sliding fee rates/categories are used for each sliding fee encounters. Explanation of disagreement with audit finding: There is no disagreement with the audit findings. Action taken in response to finding: The Corporation utilizes an external billing company. The external billing company has implemented an automated revision using robotics to ensure that sliding fee adjustments are made accurately according to the patients' sliding fee scale. Name(s) of the contact person(s) responsible for corrective action: Dave Mads…

CRITERIA Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition Found and Context During our testing of 40 sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Cause Clerical error resulted in under collection of funds from patient. Recommendation We recommend the Corporation take measures to ensure that appropriate sliding fee rates/catego…

Corrective action: 2019-001 Consolidated Health Centers Grant - CFDA 93.224 and 93.527. Recommendation: Our auditors recommended the Corporation take measures to ensure that appropriate sliding fee rates/categories are used for each sliding fee encounter. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The sliding fee transactions error that was found resulted in the under collection of funds from a patient. The front desk collected our "prepayment" amount rather than the total sliding fee because the scope of services to be performed were not known until after the dental procedures were performed. A biller incorrectly adjust…