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TABLE 9D: PATIENT RELATED REVENUE (Scope of Project Only)
Regional Summary for Region V for 2007 140 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 |
516,740,569 |
79.1% |
41.5% |
351,976,187 |
71.1% |
48.0% |
68.1% |
50,447,014 |
23,996,487 |
|
900,690 |
73,542,811 |
14.2% |
159,207,460 |
30.8% |
2a. Medicaid Managed Care (capitated)
|
32,667,421 |
5.0% |
2.6% |
41,016,028 |
8.3% |
5.6% |
125.6% |
14,625,911 |
1,213,889 |
2,353,091 |
256,494 |
17,936,397 |
54.9% |
-9,079,098 |
- 27.8% |
2b. Medicaid Managed Care (fee-for-service)
|
104,139,531 |
15.9% |
8.4% |
102,218,159 |
20.6% |
13.9% |
98.2% |
43,059,472 |
6,181,388 |
1,994,238 |
241,223 |
50,993,875 |
49.0% |
-2,934,626 |
- 2.8% |
3. Total Medicaid (Lines 1 +
2a + 2b) |
653,547,521 |
100.0% |
52.5% |
495,210,374 |
100.0% |
67.5% |
75.8% |
108,132,397 |
31,391,764 |
4,347,329 |
1,398,407 |
142,473,083 |
21.8% |
147,193,736 |
22.5% |
4. Medicare Non-Managed Care |
110,428,113 |
98.4% |
8.9% |
65,977,516 |
96.1% |
9.0% |
59.7% |
782,423 |
940,131 |
|
189,732 |
1,532,822 |
1.4% |
42,462,564 |
38.5% |
5a. Medicare Managed Care (capitated)
|
273,812 |
0.2% |
0.0% |
2,230,909 |
3.2% |
0.3% |
814.8% |
0 |
0 |
39,335 |
0 |
39,335 |
14.4% |
-1,957,097 |
- 714.8% |
5b. Medicare Managed Care (fee-for-service)
|
1,537,406 |
1.4% |
0.1% |
463,169 |
0.7% |
0.1% |
30.1% |
6,842 |
1,135 |
12,776 |
0 |
20,753 |
1.3% |
500,201 |
32.5% |
6. Total Medicare (Lines 4 +
5a + 5b) |
112,239,331 |
100.0% |
9.0% |
68,671,594 |
100.0% |
9.4% |
61.2% |
789,265 |
941,266 |
52,111 |
189,732 |
1,592,910 |
1.4% |
41,005,668 |
36.5% |
7. Other Public including Non-Medicaid
CHIP (Non Managed Care) |
10,377,563 |
96.2% |
0.8% |
5,401,480 |
95.6% |
0.7% |
52.0% |
|
|
|
0 |
0 |
0.0% |
4,351,491 |
41.9% |
8a. Other Public including Non-Medicaid
CHIP (Managed Care Capitated) |
43,545 |
0.4% |
0.0% |
106,464 |
1.9% |
0.0% |
244.5% |
|
|
0 |
0 |
0 |
0.0% |
-62,919 |
- 144.5% |
8b. Other Public including Non-Medicaid
CHIP (Managed Care fee-for-service) |
364,451 |
3.4% |
0.0% |
140,741 |
2.5% |
0.0% |
38.6% |
|
|
0 |
0 |
0 |
0.0% |
154,151 |
42.3% |
9. Total Other Public (Lines
7 + 8a + 8b) |
10,785,559 |
100.0% |
0.9% |
5,648,685 |
100.0% |
0.8% |
52.4% |
|
|
0 |
0 |
0 |
0.0% |
4,442,723 |
41.2% |
10. Private Non-Managed Care |
146,735,547 |
90.1% |
11.8% |
88,228,351 |
85.2% |
12.0% |
60.1% |
|
|
|
0 |
0 |
|
46,970,308 |
32.0% |
11a. Private Managed Care (capitated)
|
10,468,270 |
6.4% |
0.8% |
12,209,543 |
11.8% |
1.7% |
116.6% |
|
|
2,278,177 |
0 |
2,278,177 |
21.8% |
-1,741,168 |
- 16.6% |
11b. Private Managed Care (fee-for-service)
|
5,677,508 |
3.5% |
0.5% |
3,143,183 |
3.0% |
0.4% |
55.4% |
|
|
158,868 |
0 |
158,868 |
2.8% |
2,018,867 |
35.6% |
12. Total Private (Lines 10
+ 11a + 11b) |
162,881,325 |
100.0% |
13.1% |
103,581,077 |
100.0% |
14.1% |
63.6% |
|
|
2,437,045 |
0 |
2,437,045 |
1.5% |
47,248,007 |
29.0% |
13. Self-Pay |
305,235,103 |
100.0% |
24.5% |
60,867,095 |
100.0% |
8.3% |
19.9% |
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|
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|
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14. Total (Lines 3 + 6 + 9 +
12 + 13) |
1,244,688,839 |
|
100.0% |
733,978,825 |
|
100.0% |
59.0% |
108,921,662 |
32,333,030 |
6,836,485 |
1,588,139 |
146,503,038 |
11.8% |
239,890,134 |
19.3% |
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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) |
214,689,412 |
70.3% |
26,936,996 |
8.8% |
Data as of: 7/3/2008 11:44:42
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