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TABLE 9D: PATIENT RELATED REVENUE (Scope of Project Only)
State Summary for Puerto Rico for 2007
19 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 |
79,696 |
0.1% |
0.1% |
1,086 |
0.0% |
0.0% |
1.4% |
0 |
0 |
|
0 |
0 |
0.0% |
27,157 |
34.1% |
| 2a. Medicaid Managed Care (capitated)
|
81,404,937 |
82.3% |
60.2% |
71,277,893 |
84.7% |
68.5% |
87.6% |
2,225,440 |
8,435,387 |
51,045 |
0 |
10,711,872 |
13.2% |
18,288,800 |
22.5% |
| 2b. Medicaid Managed Care (fee-for-service)
|
17,425,053 |
17.6% |
12.9% |
12,911,711 |
15.3% |
12.4% |
74.1% |
0 |
17,359 |
0 |
0 |
17,359 |
0.1% |
2,751,828 |
15.8% |
| 3. Total Medicaid (Lines 1 +
2a + 2b) |
98,909,686 |
100.0% |
73.2% |
84,190,690 |
100.0% |
80.9% |
85.1% |
2,225,440 |
8,452,746 |
51,045 |
0 |
10,729,231 |
10.8% |
21,067,785 |
21.3% |
| 4. Medicare Non-Managed Care |
5,542,563 |
54.5% |
4.1% |
3,930,889 |
45.7% |
3.8% |
70.9% |
0 |
0 |
|
0 |
0 |
0.0% |
1,096,298 |
19.8% |
| 5a. Medicare Managed Care (capitated)
|
2,668,019 |
26.3% |
2.0% |
2,434,882 |
28.3% |
2.3% |
91.3% |
0 |
0 |
26,061 |
0 |
26,061 |
1.0% |
233,137 |
8.7% |
| 5b. Medicare Managed Care (fee-for-service)
|
1,953,102 |
19.2% |
1.4% |
2,231,151 |
26.0% |
2.1% |
114.2% |
0 |
23,575 |
686,152 |
0 |
709,727 |
36.3% |
101,895 |
5.2% |
| 6. Total Medicare (Lines 4 +
5a + 5b) |
10,163,684 |
100.0% |
7.5% |
8,596,922 |
100.0% |
8.3% |
84.6% |
0 |
23,575 |
712,213 |
0 |
735,788 |
7.2% |
1,431,330 |
14.1% |
| 7. Other Public including Non-Medicaid
CHIP (Non Managed Care) |
0 |
--- |
0.0% |
0 |
--- |
0.0% |
--- |
|
|
|
0 |
0 |
--- |
0 |
--- |
| 8a. Other Public including Non-Medicaid
CHIP (Managed Care Capitated) |
0 |
--- |
0.0% |
0 |
--- |
0.0% |
--- |
|
|
0 |
0 |
0 |
--- |
0 |
--- |
| 8b. Other Public including Non-Medicaid
CHIP (Managed Care fee-for-service) |
0 |
--- |
0.0% |
0 |
--- |
0.0% |
--- |
|
|
0 |
0 |
0 |
--- |
0 |
--- |
| 9. Total Other Public (Lines
7 + 8a + 8b) |
0 |
--- |
0.0% |
0 |
--- |
0.0% |
--- |
|
|
0 |
0 |
0 |
--- |
0 |
--- |
| 10. Private Non-Managed Care |
11,840,181 |
96.2% |
8.8% |
6,836,944 |
94.8% |
6.6% |
57.7% |
|
|
|
0 |
0 |
|
3,902,129 |
33.0% |
| 11a. Private Managed Care (capitated)
|
0 |
0.0% |
0.0% |
0 |
0.0% |
0.0% |
--- |
|
|
0 |
0 |
0 |
--- |
0 |
--- |
| 11b. Private Managed Care (fee-for-service)
|
461,610 |
3.8% |
0.3% |
376,839 |
5.2% |
0.4% |
81.6% |
|
|
0 |
0 |
0 |
0.0% |
0 |
0.0% |
| 12. Total Private (Lines 10
+ 11a + 11b) |
12,301,791 |
100.0% |
9.1% |
7,213,783 |
100.0% |
6.9% |
58.6% |
|
|
0 |
0 |
0 |
0.0% |
3,902,129 |
31.7% |
| 13. Self-Pay |
13,793,747 |
100.0% |
10.2% |
4,099,720 |
100.0% |
3.9% |
29.7% |
|
|
|
|
|
|
|
|
| 14. Total (Lines 3 + 6 + 9 +
12 + 13) |
135,168,908 |
|
100.0% |
104,101,115 |
|
100.0% |
77.0% |
2,225,440 |
8,476,321 |
763,258 |
0 |
11,465,019 |
8.5% |
26,401,244 |
19.5% |
|
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) |
8,503,473 |
61.6% |
1,077,497 |
7.8% |
data as of: 7/22/2008 4:05:02
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