Please enter the information indicated below.
Bed Size (Total # licensed beds)
Beds in Service (Total # operational beds)
Average Daily Census (Average daily inpatient census)
Total Accounts Receivable $ (Dollar of open patient accounts where money owed for services provided. Do not include $ written off to bad debt)
Cash Receipts Per Month $ (Cash received as payment on accounts for monthly reporting period)
Gross Revenue Per Month $ (Total billing on accounts for services for monthly reporting period)
Accounts Receivable $ over 90 days $ (Total dollar amount of open accounts > 90 days. Do not include accounts written off to bad debt)
Monthly Cost of Registration $ (Total salaries/wages for those in registration and admissions for monthly reporting period)
Monthly Cost of Billing/Collection and Cash Posting (Total salaries/wages for those in business office(billing, collection, cash posting) for monthly reporting period.)
Administrative Write-Off $'s Per Month $ (Dollar amount of accounts written off as administrative. Not including Contractual.)
Charity Write-Off $'s Per Month $ (Dollar amount of accounts written off as charity)
Bad Debt Write-off $'s per Month (dollar amount of accouts written off as Bad Debt)
Number of Open Accounts (Number open accounts worked by business office. Do not include accounts assigned to collection agencies, financial classes assigned to outsource vendors)
Percentage of AR in Self Pay >90 days % (Determined by taking the total self pay dollars in AR > 90 and dividing by total dollars in AR >90. Do not include accounts referred to outside collection agency)
Number of Days Cash on Hand (Cash on hand divided by average cash usage per day for hospital expenses)
Amount of $ Discharged Days not Final Billed (DNFB) $ (Dollar amount of accounts on patients discharged & billing not sent)
When was your Chargemaster Last Updated? (dd/mm/yy) (Date ChargeMaster completely updated using latest code changes and pricing)
Date Data Compiled (dd/mm/yy) (Date information compiled on your Information System)
What is your Patient Accounting System? (Hospital's main Health Information System (Meditech, Dairyland, CPSI, etc)
Do you have an EMR or are you planning to purchase a system, and if so, which one?