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TABLE 9D: PATIENT RELATED REVENUE (Scope of Project Only)
Regional Summary for Region I for 2007 84 Grantees
Payor Category |
Full
Charges This Period (a) |
Charges
as Percent of Payor |
Charges
as Percent of Total |
Amount
Collected This Period (b) |
Collections
as Percent of Payor |
Collections
as Percent of Total |
Collections
as Percent of Charges |
Collection
of recon./wrap around Current Year (c1) |
Collection
of recon./wrap around Previous Years
(c2) |
Collection
of other retroactive payments (c3) |
Penalty/Payback
(c4) |
Net
Retros |
Net
Retros as Percent of Charges |
Allowances
(d) |
Allowances
as Percent of Charges |
1. Medicaid Non-Managed Care |
187,585,792 |
54.1% |
23.8% |
133,926,629 |
51.3% |
28.7% |
71.4% |
711,769 |
1,814,491 |
|
803,900 |
1,722,360 |
0.9% |
47,687,120 |
25.4% |
2a. Medicaid Managed Care (capitated)
|
35,121,943 |
10.1% |
4.4% |
35,330,216 |
13.5% |
7.6% |
100.6% |
11,255,696 |
1,365,773 |
2,343,955 |
0 |
14,965,424 |
42.6% |
456,545 |
1.3% |
2b. Medicaid Managed Care (fee-for-service)
|
123,911,427 |
35.7% |
15.7% |
91,578,699 |
35.1% |
19.6% |
73.9% |
13,171,633 |
2,847,346 |
165,196 |
16,378 |
16,167,797 |
13.0% |
35,803,743 |
28.9% |
3. Total Medicaid (Lines 1 +
2a + 2b) |
346,619,162 |
100.0% |
43.9% |
260,835,544 |
100.0% |
55.9% |
75.3% |
25,139,098 |
6,027,610 |
2,509,151 |
820,278 |
32,855,581 |
9.5% |
83,947,408 |
24.2% |
4. Medicare Non-Managed Care |
78,313,550 |
97.1% |
9.9% |
55,299,965 |
97.0% |
11.9% |
70.6% |
121,939 |
522,578 |
|
6,028 |
638,489 |
0.8% |
18,174,050 |
23.2% |
5a. Medicare Managed Care (capitated)
|
379,489 |
0.5% |
0.0% |
504,580 |
0.9% |
0.1% |
133.0% |
0 |
0 |
298,143 |
0 |
298,143 |
78.6% |
-125,090 |
- 33.0% |
5b. Medicare Managed Care (fee-for-service)
|
1,924,241 |
2.4% |
0.2% |
1,229,260 |
2.2% |
0.3% |
63.9% |
48,267 |
34,250 |
5,226 |
0 |
87,743 |
4.6% |
586,403 |
30.5% |
6. Total Medicare (Lines 4 +
5a + 5b) |
80,617,280 |
100.0% |
10.2% |
57,033,805 |
100.0% |
12.2% |
70.7% |
170,206 |
556,828 |
303,369 |
6,028 |
1,024,375 |
1.3% |
18,635,363 |
23.1% |
7. Other Public including Non-Medicaid
CHIP (Non Managed Care) |
18,713,722 |
39.9% |
2.4% |
11,429,101 |
43.4% |
2.5% |
61.1% |
|
|
|
2,409 |
-2,409 |
- 0.0% |
5,294,902 |
28.3% |
8a. Other Public including Non-Medicaid
CHIP (Managed Care Capitated) |
9,297 |
0.0% |
0.0% |
51,030 |
0.2% |
0.0% |
548.9% |
|
|
0 |
0 |
0 |
0.0% |
-41,590 |
- 447.3% |
8b. Other Public including Non-Medicaid
CHIP (Managed Care fee-for-service) |
28,122,377 |
60.0% |
3.6% |
14,862,785 |
56.4% |
3.2% |
52.9% |
|
|
0 |
0 |
0 |
0.0% |
9,866,241 |
35.1% |
9. Total Other Public (Lines
7 + 8a + 8b) |
46,845,396 |
100.0% |
5.9% |
26,342,916 |
100.0% |
5.6% |
56.2% |
|
|
0 |
2,409 |
-2,409 |
- 0.0% |
15,119,553 |
32.3% |
10. Private Non-Managed Care |
113,483,690 |
78.1% |
14.4% |
71,203,860 |
78.9% |
15.3% |
62.7% |
|
|
|
1,235 |
-1,235 |
|
37,266,941 |
32.8% |
11a. Private Managed Care (capitated)
|
847,633 |
0.6% |
0.1% |
533,433 |
0.6% |
0.1% |
62.9% |
|
|
34,773 |
0 |
34,773 |
4.1% |
289,638 |
34.2% |
11b. Private Managed Care (fee-for-service)
|
31,028,365 |
21.3% |
3.9% |
18,550,227 |
20.5% |
4.0% |
59.8% |
|
|
350,782 |
40,945 |
309,837 |
1.0% |
11,939,092 |
38.5% |
12. Total Private (Lines 10
+ 11a + 11b) |
145,359,688 |
100.0% |
18.4% |
90,287,520 |
100.0% |
19.4% |
62.1% |
|
|
385,555 |
42,180 |
343,375 |
0.2% |
49,495,671 |
34.1% |
13. Self-Pay |
170,156,872 |
100.0% |
21.5% |
31,974,791 |
100.0% |
6.9% |
18.8% |
|
|
|
|
|
|
|
|
14. Total (Lines 3 + 6 + 9 +
12 + 13) |
789,598,398 |
|
100.0% |
466,474,576 |
|
100.0% |
59.1% |
25,309,304 |
6,584,438 |
3,198,075 |
870,895 |
34,220,922 |
4.3% |
167,197,995 |
21.2% |
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Sliding Discounts (e) |
Sliding Discounts as a Percent of Self-Pay
Charges |
Bad Debt Write Off(f) |
Bad Debt as Percent of Self-Pay
Charges |
13. Self-Pay (line 14 is same) |
122,834,297 |
72.2% |
14,107,458 |
8.3% |
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