Skip to main content

Table 9D: Patient Related Revenue

Federated States of Micronesia Data

X

4 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 $0 0.00% $0 0.00%
2a. Medicaid Managed Care (capitated) $0 0.00% $0 0.00%
2b. Medicaid Managed Care (fee-for-service) $0 0.00% $0 0.00%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $0 0.00% $0 0.00%
4. Medicare Non-Managed Care $0 0.00% $0 0.00%
5a. Medicare Managed Care (capitated) $0 0.00% $0 0.00%
5b. Medicare Managed Care (fee-for-service) $0 0.00% $0 0.00%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $0 0.00% $0 0.00%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $254,059 100.00% 26.88% $78,752 100.00% 53.66% 31.00%
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) $254,059 100.00% 26.88% $78,752 100.00% 53.66% 31.00%
10. Private Non-Managed Care $0 0.00% $0 0.00%
11a. Private Managed Care (capitated) $0 0.00% $0 0.00%
11b. Private Managed Care (fee-for-service) $0 0.00% $0 0.00%
12. Total Private (Sum of Lines 10 + 11a + 11b) $0 0.00% $0 0.00%
13. Self-Pay $691,224 100.00% 73.12% $68,021 100.00% 46.34% 9.84%
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $945,283 100.00% $146,773 100.00% 15.53%
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
2a. Medicaid Managed Care (capitated) $0 $0 $0 $0 $0 $0
2b. Medicaid Managed Care (fee-for-service) $0 $0 $0 $0 $0 $0
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $0 $0 $0 $0 $0 $0
4. Medicare Non-Managed Care $0 $0 $0 $0 $0 $0
5a. Medicare Managed Care (capitated) $0 $0 $0 $0 $0 $0
5b. Medicare Managed Care (fee-for-service) $0 $0 $0 $0 $0 $0
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $0 $0 $0 $0 $0 $0
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $0 $0 $0 $0 $0 0.00% $1,500 0.59%
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% $1,500 0.59%
10. Private Non-Managed Care $0 $0 $0 $0
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
13. Self-Pay
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $0 $0 $0 $0 $0 0.00% $1,500 0.16%
Line Sliding Fee Discounts (e)
$
Bad Debt Write-Off (f)
$
13. Self-Pay $580,348 $41,336

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

Accessibility Statement:
Persons using assistive technology may not be able to fully access information in these files. For assistance, contact the Health Center Program Support at: 877-464-4772.