Table 9D: Patient Related Revenue
New Jersey Data
23 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 | $86,842,498 | 24.08% | 14.47% | $48,038,036 | 20.22% | 15.90% | 55.32% |
| 2a. | Medicaid Managed Care (capitated) | $98,349,204 | 27.27% | 16.39% | $59,760,104 | 25.16% | 19.78% | 60.76% |
| 2b. | Medicaid Managed Care (fee-for-service) | $175,451,350 | 48.65% | 29.23% | $129,758,529 | 54.62% | 42.95% | 73.96% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $360,643,052 | 100.00% | 60.09% | $237,556,669 | 100.00% | 78.63% | 65.87% |
| 4. | Medicare Non-Managed Care | $22,869,256 | 74.28% | 3.81% | $9,168,573 | 72.87% | 3.03% | 40.09% |
| 5a. | Medicare Managed Care (capitated) | $81,451 | 0.26% | 0.01% | $35,507 | 0.28% | 0.01% | 43.59% |
| 5b. | Medicare Managed Care (fee-for-service) | $7,838,092 | 25.46% | 1.31% | $3,378,851 | 26.85% | 1.12% | 43.11% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $30,788,799 | 100.00% | 5.13% | $12,582,931 | 100.00% | 4.16% | 40.87% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $5,637,646 | 100.00% | 0.94% | $4,532,544 | 100.00% | 1.50% | 80.40% |
| 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% | |
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b) | $5,637,646 | 100.00% | 0.94% | $4,532,544 | 100.00% | 1.50% | 80.40% |
| 10. | Private Non-Managed Care | $55,781,187 | 94.09% | 9.29% | $19,350,892 | 92.71% | 6.40% | 34.69% |
| 11a. | Private Managed Care (capitated) | $311,574 | 0.53% | 0.05% | $180,202 | 0.86% | 0.06% | 57.84% |
| 11b. | Private Managed Care (fee-for-service) | $3,189,612 | 5.38% | 0.53% | $1,341,800 | 6.43% | 0.44% | 42.07% |
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $59,282,373 | 100.00% | 9.88% | $20,872,894 | 100.00% | 6.91% | 35.21% |
| 13. | Self-Pay | $143,823,605 | 100.00% | 23.96% | $26,578,153 | 100.00% | 8.80% | 18.48% |
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $600,175,475 | 100.00% | $302,123,191 | 100.00% | 50.34% | ||
| 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 | $3,764,542 | $1,475,962 | $0 | $1,064 | $5,239,440 | 6.03% | $36,834,751 | 42.42% |
| 2a. | Medicaid Managed Care (capitated) | $22,519,726 | $9,885,567 | $0 | $346,162 | $32,059,131 | 32.60% | $38,494,340 | 39.14% |
| 2b. | Medicaid Managed Care (fee-for-service) | $54,668,710 | $29,392,377 | $195,246 | $210,366 | $84,045,967 | 47.90% | $36,893,934 | 21.03% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $80,952,978 | $40,753,906 | $195,246 | $557,592 | $121,344,538 | 33.65% | $112,223,025 | 31.12% |
| 4. | Medicare Non-Managed Care | $0 | $85,055 | $2,140 | $0 | $87,195 | 0.38% | $11,406,929 | 49.88% |
| 5a. | Medicare Managed Care (capitated) | $0 | $0 | $0 | $0 | $0 | 0.00% | $45,944 | 56.41% |
| 5b. | Medicare Managed Care (fee-for-service) | $0 | $0 | $0 | $0 | $0 | 0.00% | $3,919,396 | 50.00% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $0 | $85,055 | $2,140 | $0 | $87,195 | 0.28% | $15,372,269 | 49.93% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $0 | $0 | $0 | $0 | $0 | 0.00% | $600,890 | 10.66% |
| 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 | ||
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b) | $0 | $0 | $0 | $0 | $0 | 0.00% | $600,890 | 10.66% |
| 10. | Private Non-Managed Care | $0 | $0 | $0 | 0.00% | $33,889,177 | 60.75% | ||
| 11a. | Private Managed Care (capitated) | $0 | $0 | $0 | 0.00% | $118,932 | 38.17% | ||
| 11b. | Private Managed Care (fee-for-service) | $0 | $0 | $0 | 0.00% | $1,585,449 | 49.71% | ||
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $0 | $0 | $0 | 0.00% | $35,593,558 | 60.04% | ||
| 13. | Self-Pay | ||||||||
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $80,952,978 | $40,838,961 | $197,386 | $557,592 | $121,431,733 | 20.23% | $163,789,742 | 27.29% |
| Line | Sliding Fee Discounts (e) $ |
Bad Debt Write-Off (f) $ |
|
|---|---|---|---|
| 13. | Self-Pay | $98,833,545 | $8,563,843 |
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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