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Table 9D: Patient Related Revenue

South Carolina Data

X

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 $42,826,204 27.27% 4.32% $36,177,985 23.30% 5.50% 84.48%
2a. Medicaid Managed Care (capitated) $0 0.00% 0.00% $0 0.00% 0.00%
2b. Medicaid Managed Care (fee-for-service) $114,241,627 72.73% 11.51% $119,121,984 76.70% 18.09% 104.27%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $157,067,831 100.00% 15.83% $155,299,969 100.00% 23.59% 98.87%
4. Medicare Non-Managed Care $216,661,178 70.77% 21.84% $164,129,962 78.19% 24.93% 75.75%
5a. Medicare Managed Care (capitated) $0 0.00% 0.00% $0 0.00% 0.00%
5b. Medicare Managed Care (fee-for-service) $89,478,963 29.23% 9.02% $45,791,730 21.81% 6.96% 51.18%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $306,140,141 100.00% 30.86% $209,921,692 100.00% 31.89% 68.57%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $909,688 32.61% 0.09% $323,835 65.01% 0.05% 35.60%
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) $1,880,096 67.39% 0.19% $174,279 34.99% 0.03% 9.27%
9. Total Other Public (Sum of Lines 7 + 8a + 8b) $2,789,784 100.00% 0.28% $498,114 100.00% 0.08% 17.85%
10. Private Non-Managed Care $313,833,812 86.69% 31.63% $224,377,891 87.44% 34.08% 71.50%
11a. Private Managed Care (capitated) $0 0.00% 0.00% $0 0.00% 0.00%
11b. Private Managed Care (fee-for-service) $48,192,607 13.31% 4.86% $32,228,241 12.56% 4.90% 66.87%
12. Total Private (Sum of Lines 10 + 11a + 11b) $362,026,419 100.00% 36.49% $256,606,132 100.00% 38.98% 70.88%
13. Self-Pay $164,091,021 100.00% 16.54% $36,010,956 100.00% 5.47% 21.95%
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $992,115,196 100.00% $658,336,863 100.00% 66.36%
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 $1,067,874 $388,479 $238,489 $383 $1,694,459 3.96% $4,849,777 11.32%
2a. Medicaid Managed Care (capitated) $0 $0 $0 $0 $0 $0
2b. Medicaid Managed Care (fee-for-service) $1,052,558 $528,466 $4,758,760 $0 $6,339,784 5.55% $1,493,129 1.31%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $2,120,432 $916,945 $4,997,249 $383 $8,034,243 5.12% $6,342,906 4.04%
4. Medicare Non-Managed Care $0 $737,782 $208,174 $12 $945,944 0.44% $56,574,080 26.11%
5a. Medicare Managed Care (capitated) $0 $0 $0 $0 $0 $0
5b. Medicare Managed Care (fee-for-service) $0 $0 $482,694 $188 $482,506 0.54% $35,101,936 39.23%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $0 $737,782 $690,868 $200 $1,428,450 0.47% $91,676,016 29.95%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $0 $0 $0 $0 $0 0.00% $396,562 43.59%
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 0.00% $353,436 18.80%
9. Total Other Public (Sum of Lines 7 + 8a + 8b) $0 $0 $0 $0 $0 0.00% $749,998 26.88%
10. Private Non-Managed Care $1,412,490 $102 $1,412,388 0.45% $59,244,716 18.88%
11a. Private Managed Care (capitated) $0 $0 $0 $0
11b. Private Managed Care (fee-for-service) $0 $0 $0 0.00% $9,928,701 20.60%
12. Total Private (Sum of Lines 10 + 11a + 11b) $1,412,490 $102 $1,412,388 0.39% $69,173,417 19.11%
13. Self-Pay
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $2,120,432 $1,654,727 $7,100,607 $685 $10,875,081 1.10% $167,942,337 16.93%
Line Sliding Fee Discounts (e)
$
Bad Debt Write-Off (f)
$
13. Self-Pay $105,252,853 $13,034,096

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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