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HRSA Health Resources & Services Administration

Table 9D: Patient Related Revenue

North Carolina Data

39 Awardees

Line Payer Category Charges Collections
Full Charges This Period (a)
$
% of Payer % of Total Amount Collected This Period (b)
$
% of Payer % of Total % of Charges
1. Medicaid Non-Managed Care $109,810,551 69.74% 14.85% $80,037,023 67.11% 18.52% 72.89%
2a. Medicaid Managed Care (capitated) $3,424,087 2.17% 0.46% $2,454,776 2.06% 0.57% 71.69%
2b. Medicaid Managed Care (fee-for-service) $44,228,201 28.09% 5.98% $36,761,892 30.83% 8.50% 83.12%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $157,462,839 100.00% 21.29% $119,253,691 100.00% 27.59% 75.73%
4. Medicare Non-Managed Care $151,072,441 97.15% 20.43% $104,577,050 96.89% 24.19% 69.22%
5a. Medicare Managed Care (capitated) $287,843 0.19% 0.04% $214,798 0.20% 0.05% 74.62%
5b. Medicare Managed Care (fee-for-service) $4,139,898 2.66% 0.56% $3,146,824 2.92% 0.73% 76.01%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $155,500,182 100.00% 21.03% $107,938,672 100.00% 24.97% 69.41%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $3,716,251 28.20% 0.50% $1,733,895 22.93% 0.40% 46.66%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $0 0.00% 0.00% $0 0.00% 0.00%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $0 0.00% 0.00% $0 0.00% 0.00%
8c. Other Public, including COVID-19 Uninsured Program $9,463,301 71.80% 1.28% $5,827,029 77.07% 1.35% 61.58%
9. Total Other Public (Sum of Lines 7 + 8a + 8b + 8c) $13,179,552 100.00% 1.78% $7,560,924 100.00% 1.75% 57.37%
10. Private Non-Managed Care $203,566,344 98.84% 27.53% $143,311,618 98.63% 33.15% 70.40%
11a. Private Managed Care (capitated) $0 0.00% 0.00% $0 0.00% 0.00%
11b. Private Managed Care (fee-for-service) $2,383,180 1.16% 0.32% $1,996,723 1.37% 0.46% 83.78%
12. Total Private (Sum of Lines 10 + 11a + 11b) $205,949,524 100.00% 27.85% $145,308,341 100.00% 33.62% 70.56%
13. Self-Pay $207,426,710 100.00% 28.05% $52,198,951 100.00% 12.08% 25.17%
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $739,518,807 100.00% $432,260,579 100.00% 58.45%
Line Payer Category Retroactive Settlements, Receipts, and Paybacks(c) Adjustments
Collection of Reconciliation
/Wraparound Current Year(c1)
$
Collection of Reconciliation
/Wraparound Previous Years(c2)
$
Collection of Other Payments: P4P, Risk Pools, etc.(c3)
$
Penalty/ Payback (c4)
$
Net Retros
$
Net Retros % of Charges Adjustments (d)
$
Adjustments % of Charges
1. Medicaid Non-Managed Care $4,160,995 $16,322,320 $464,397 $445,156 $20,502,556 18.67% $26,025,410 23.70%
2a. Medicaid Managed Care (capitated) $176,555 $45,486 $356,454 $0 $578,495 16.89% $1,261,026 36.83%
2b. Medicaid Managed Care (fee-for-service) $3,075,594 $2,191,250 $2,737,621 $0 $8,004,465 18.10% $12,652,553 28.61%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $7,413,144 $18,559,056 $3,558,472 $445,156 $29,085,516 18.47% $39,938,989 25.36%
4. Medicare Non-Managed Care $392,363 $2,255,086 $1,754,968 $20,291 $4,382,126 2.90% $49,560,718 32.81%
5a. Medicare Managed Care (capitated) $0 $0 $0 $0 $0 0.00% $69,649 24.20%
5b. Medicare Managed Care (fee-for-service) $0 $0 $28,246 $0 $28,246 0.68% $1,240,702 29.97%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $392,363 $2,255,086 $1,783,214 $20,291 $4,410,372 2.84% $50,871,069 32.71%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $0 $0 $0 $0 $0 0.00% $1,943,708 52.30%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $0 $0 $0 $0 $0 $0
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $0 $0 $0 $0 $0 $0
8c. Other Public, including COVID-19 Uninsured Program $0 $0 $0 0.00% $4,095,975 43.28%
9. Total Other Public (Sum of Lines 7 + 8a + 8b + 8c) $0 $0 $0 $0 $0 0.00% $6,039,683 45.83%
10. Private Non-Managed Care $687,540 $929 $686,611 0.34% $47,069,949 23.12%
11a. Private Managed Care (capitated) $0 $0 $0 $0
11b. Private Managed Care (fee-for-service) $0 $0 $0 0.00% $921,054 38.65%
12. Total Private (Sum of Lines 10 + 11a + 11b) $687,540 $929 $686,611 0.33% $47,991,003 23.30%
13. Self-Pay
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $7,805,507 $20,814,142 $6,029,226 $466,376 $34,182,499 4.62% $144,840,744 19.59%
Line Sliding Fee Discounts (e)
$
Bad Debt Write-Off (f)
$
13. Self-Pay $131,948,975 $17,443,049

Footnotes

'-' Data cannot be calculated or has been suppressed for confidentiality purposes.

Cells that are shaded blue represent data that was not reported or null values.

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