Table 9D: Patient Related Revenue
Puerto Rico Data
21 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 | $208,492 | 0.05% | 0.04% | $189,994 | 0.05% | 0.04% | 91.13% |
| 2a. | Medicaid Managed Care (capitated) | $227,144,913 | 57.57% | 40.16% | $266,370,151 | 68.40% | 52.96% | 117.27% |
| 2b. | Medicaid Managed Care (fee-for-service) | $167,231,950 | 42.38% | 29.57% | $122,874,959 | 31.55% | 24.43% | 73.48% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $394,585,355 | 100.00% | 69.77% | $389,435,104 | 100.00% | 77.43% | 98.69% |
| 4. | Medicare Non-Managed Care | $7,491,262 | 7.38% | 1.32% | $4,239,920 | 5.67% | 0.84% | 56.60% |
| 5a. | Medicare Managed Care (capitated) | $29,275,577 | 28.86% | 5.18% | $23,558,808 | 31.51% | 4.68% | 80.47% |
| 5b. | Medicare Managed Care (fee-for-service) | $64,688,165 | 63.76% | 11.44% | $46,976,306 | 62.82% | 9.34% | 72.62% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $101,455,004 | 100.00% | 17.94% | $74,775,034 | 100.00% | 14.87% | 73.70% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $0 | 0.00% | $0 | 0.00% | |||
| 8a. | Other Public, including Non-Medicaid CHIP, Managed Care (capitated) | $0 | 0.00% | $0 | 0.00% | |||
| 8b. | Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) | $0 | 0.00% | $0 | 0.00% | |||
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b) | $0 | 0.00% | $0 | 0.00% | |||
| 10. | Private Non-Managed Care | $44,206,698 | 100.00% | 7.82% | $24,572,338 | 100.00% | 4.89% | 55.59% |
| 11a. | Private Managed Care (capitated) | $0 | 0.00% | 0.00% | $0 | 0.00% | 0.00% | |
| 11b. | Private Managed Care (fee-for-service) | $0 | 0.00% | 0.00% | $0 | 0.00% | 0.00% | |
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $44,206,698 | 100.00% | 7.82% | $24,572,338 | 100.00% | 4.89% | 55.59% |
| 13. | Self-Pay | $25,313,540 | 100.00% | 4.48% | $14,186,751 | 100.00% | 2.82% | 56.04% |
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $565,560,597 | 100.00% | $502,969,227 | 100.00% | 88.93% | ||
| 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 | $0 | $0 | $0 | $0 | $0 | 0.00% | $6,695 | 3.21% |
| 2a. | Medicaid Managed Care (capitated) | $80,813,546 | $71,372,991 | $1,820,881 | $88,759 | $153,918,659 | 67.76% | ($39,225,238.00) | -17.27% |
| 2b. | Medicaid Managed Care (fee-for-service) | $2,882,617 | $1,839,744 | $0 | $46 | $4,722,315 | 2.82% | $33,669,598 | 20.13% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $83,696,163 | $73,212,735 | $1,820,881 | $88,805 | $158,640,974 | 40.20% | ($5,548,945.00) | -1.41% |
| 4. | Medicare Non-Managed Care | $179,550 | $264,766 | $0 | $0 | $444,316 | 5.93% | $1,470,375 | 19.63% |
| 5a. | Medicare Managed Care (capitated) | $0 | $0 | $184,145 | $0 | $184,145 | 0.63% | $5,716,769 | 19.53% |
| 5b. | Medicare Managed Care (fee-for-service) | $0 | $0 | $0 | $4,738 | ($4,738.00) | -0.01% | $13,200,232 | 20.41% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $179,550 | $264,766 | $184,145 | $4,738 | $623,723 | 0.61% | $20,387,376 | 20.09% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $0 | $0 | $0 | $0 | $0 | $0 | ||
| 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 | ||
| 10. | Private Non-Managed Care | $0 | $0 | $0 | 0.00% | $11,503,752 | 26.02% | ||
| 11a. | Private Managed Care (capitated) | $0 | $0 | $0 | $0 | ||||
| 11b. | Private Managed Care (fee-for-service) | $0 | $0 | $0 | $0 | ||||
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $0 | $0 | $0 | 0.00% | $11,503,752 | 26.02% | ||
| 13. | Self-Pay | ||||||||
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $83,875,713 | $73,477,501 | $2,005,026 | $93,543 | $159,264,697 | 28.16% | $26,342,183 | 4.66% |
| Line | Sliding Fee Discounts (e) $ |
Bad Debt Write-Off (f) $ |
|
|---|---|---|---|
| 13. | Self-Pay | $5,640,299 | $2,743,907 |
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.
View Detailed UDS Footnotes
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