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TABLE 9D: PATIENT RELATED REVENUE (Scope of Project Only)
State Summary for Pennsylvania for 2007
32 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 |
26,024,866 |
24.4% |
11.4% |
17,980,058 |
20.8% |
12.5% |
69.1% |
61,006 |
20,121 |
|
0 |
81,127 |
0.3% |
6,414,099 |
24.6% |
| 2a. Medicaid Managed Care (capitated)
|
36,858,874 |
34.6% |
16.1% |
36,561,729 |
42.2% |
25.3% |
99.2% |
9,872,262 |
5,421,902 |
660,512 |
0 |
15,954,676 |
43.3% |
3,521,141 |
9.6% |
| 2b. Medicaid Managed Care (fee-for-service)
|
43,686,705 |
41.0% |
19.1% |
32,006,976 |
37.0% |
22.2% |
73.3% |
12,747,911 |
5,629,955 |
36,666 |
0 |
18,414,532 |
42.2% |
17,286,234 |
39.6% |
| 3. Total Medicaid (Lines 1 +
2a + 2b) |
106,570,445 |
100.0% |
46.7% |
86,548,763 |
100.0% |
60.0% |
81.2% |
22,681,179 |
11,071,978 |
697,178 |
0 |
34,450,335 |
32.3% |
27,221,474 |
25.5% |
| 4. Medicare Non-Managed Care |
19,848,667 |
72.0% |
8.7% |
13,743,806 |
77.8% |
9.5% |
69.2% |
184,599 |
316,513 |
|
0 |
501,112 |
2.5% |
4,622,416 |
23.3% |
| 5a. Medicare Managed Care (capitated)
|
393,599 |
1.4% |
0.2% |
154,236 |
0.9% |
0.1% |
39.2% |
0 |
0 |
1,875 |
0 |
1,875 |
0.5% |
239,363 |
60.8% |
| 5b. Medicare Managed Care (fee-for-service)
|
7,341,421 |
26.6% |
3.2% |
3,758,822 |
21.3% |
2.6% |
51.2% |
21,838 |
100,380 |
132,834 |
0 |
255,052 |
3.5% |
3,516,861 |
47.9% |
| 6. Total Medicare (Lines 4 +
5a + 5b) |
27,583,687 |
100.0% |
12.1% |
17,656,864 |
100.0% |
12.2% |
64.0% |
206,437 |
416,893 |
134,709 |
0 |
758,039 |
2.7% |
8,378,640 |
30.4% |
| 7. Other Public including Non-Medicaid
CHIP (Non Managed Care) |
837,917 |
47.1% |
0.4% |
352,761 |
42.5% |
0.2% |
42.1% |
|
|
|
0 |
0 |
0.0% |
420,953 |
50.2% |
| 8a. Other Public including Non-Medicaid
CHIP (Managed Care Capitated) |
472,462 |
26.6% |
0.2% |
304,627 |
36.7% |
0.2% |
64.5% |
|
|
11,603 |
0 |
11,603 |
2.5% |
175,346 |
37.1% |
| 8b. Other Public including Non-Medicaid
CHIP (Managed Care fee-for-service) |
466,825 |
26.3% |
0.2% |
172,533 |
20.8% |
0.1% |
37.0% |
|
|
0 |
0 |
0 |
0.0% |
76,007 |
16.3% |
| 9. Total Other Public (Lines
7 + 8a + 8b) |
1,777,204 |
100.0% |
0.8% |
829,921 |
100.0% |
0.6% |
46.7% |
|
|
11,603 |
0 |
11,603 |
0.7% |
672,306 |
37.8% |
| 10. Private Non-Managed Care |
35,554,084 |
70.4% |
15.6% |
22,833,596 |
75.9% |
15.8% |
64.2% |
|
|
|
0 |
0 |
|
11,247,792 |
31.6% |
| 11a. Private Managed Care (capitated)
|
4,717,148 |
9.3% |
2.1% |
2,994,312 |
10.0% |
2.1% |
63.5% |
|
|
144,187 |
0 |
144,187 |
3.1% |
1,828,943 |
38.8% |
| 11b. Private Managed Care (fee-for-service)
|
10,244,923 |
20.3% |
4.5% |
4,240,370 |
14.1% |
2.9% |
41.4% |
|
|
832 |
0 |
832 |
0.0% |
5,114,846 |
49.9% |
| 12. Total Private (Lines 10
+ 11a + 11b) |
50,516,155 |
100.0% |
22.1% |
30,068,278 |
100.0% |
20.8% |
59.5% |
|
|
145,019 |
0 |
145,019 |
0.3% |
18,191,581 |
36.0% |
| 13. Self-Pay |
41,833,526 |
100.0% |
18.3% |
9,175,280 |
100.0% |
6.4% |
21.9% |
|
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|
|
|
|
|
|
| 14. Total (Lines 3 + 6 + 9 +
12 + 13) |
228,281,017 |
|
100.0% |
144,279,106 |
|
100.0% |
63.2% |
22,887,616 |
11,488,871 |
988,509 |
0 |
35,364,996 |
15.5% |
54,464,001 |
23.9% |
|
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) |
27,872,585 |
66.6% |
4,533,824 |
10.8% |
data as of: 7/22/2008 4:03:53
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