Page 178 - Financial Workbook October

Date: Dec 4, 2017 Towne Square Care of Puryear - SNF
Time: 16:52:03 CT A/R Aging by Service Date
User: Zach Bell December 2017 Page # 1

Status: Both Buckets: PCC Default Payers: All
Resident Name (ID) Total Future Cash Current 30 60 90 120 150 180 210
+ 12/17 12/17 11/17 10/17 09/17 08/17 07/17 06/17 + 05/17

Payer: Amerigroup AMG
Barker, Lori (BARK L) $21,048.22 $0.00 $5,300.07 $5,129.10 $5,300.07 $9.30 $9.61 $5,300.07 $0.00 $0.00
Beazley, Rosalie (BEAZ R) $14,719.76 $0.00 $4,954.07 $4,783.10 $4,954.07 $9.30 $9.61 $9.61 $0.00 $0.00
Bell, Elsie (BELL E) ($5,013.11) $0.00 $0.00 $0.00 $0.00 $0.00 ($5,022.72) $9.61 $0.00 $0.00
Brunzel, Sandra (BRUN S) $13,264.76 $0.00 $4,469.07 $4,298.10 $4,469.07 $9.30 $9.61 $9.61 $0.00 $0.00
Erwin, Wanda (ERWI W) $12,919.22 $0.00 $4,353.89 $4,182.92 $4,353.89 $9.30 $9.61 $9.61 $0.00 $0.00
Fitzgerald, Thomas (FITZ T) $7,164.59 $0.00 $0.00 $2,786.00 $4,350.07 $9.30 $9.61 $9.61 $0.00 $0.00
Krolak, Donald (KROL D) $10,387.92 $0.00 $4,191.97 $4,021.00 $4,191.97 $9.30 $9.61 ($1,098.49) ($937.44) $0.00
Moon, Clara (MOON C) $3,209.66 $0.00 $0.00 $1,445.07 $4,112.07 $9.30 ($2,366.39) $9.61 $0.00 $0.00
Sanders, Jessye (SAND J) $13,555.76 $0.00 $4,566.07 $4,395.10 $4,566.07 $9.30 $9.61 $9.61 $0.00 $0.00
Sykes, Martha (SYKE) $7.20 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.20
TOTAL $91,263.98 $0.00 $27,835.14 $31,040.39 $36,297.28 $74.40 ($7,321.84) $4,268.85 ($937.44) $7.20
Payer: Hospice Medicaid TN HMT
Bell, Elsie (BELL E) ($132.77) $0.00 $0.00 $0.00 $0.00 ($132.72) ($0.05) $0.00 $0.00 $0.00
Cowsert, Frances (COWSF) $10,452.42 $0.00 $5,300.07 $5,129.10 $9.61 $9.30 $4.34 $0.00 $0.00 $0.00
RAINEY, BERNICE (RAINB) $4,340.89 $0.00 $5,014.53 $4,843.56 $0.00 $0.00 ($0.30) $0.00 $0.00 ($5,516.90)
Sanders, Henry (SAND H) $3,468.44 $0.00 $4,147.78 $3,976.81 $0.00 ($3.00) $0.00 $0.00 $0.00 ($4,653.15)
Sykes, Helen (SYKE H) ($170.36) $0.00 $0.00 $0.00 $0.00 $0.00 ($176.66) $6.30 $0.00 $0.00
Sykes, Martha (SYKE) ($1,091.13) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ($1,092.53) $1.40
TOTAL $16,867.49 $0.00 $14,462.38 $13,949.47 $9.61 ($126.42) ($172.67) $6.30 ($1,092.53) ($10,168.65)
Payer: Hospice Private HP
Bogard, Mary (BOGA M) ($1,155.00) $0.00 $0.00 $0.00 $0.00 $0.00 ($1,155.00) $0.00 $0.00 $0.00
Jones, Elaine (JONEE) ($495.00) $0.00 $0.00 $0.00 $0.00 ($495.00) $0.00 $0.00 $0.00 $0.00
TOTAL ($1,650.00) $0.00 $0.00 $0.00 $0.00 ($495.00) ($1,155.00) $0.00 $0.00 $0.00
Payer: Managed Care - Blue Cross Blue Shield BC
CARPENTER, JACKIE (CARPJ) $19,585.35 $0.00 $0.00 $12,434.89 $7,150.46 $0.00 $0.00 $0.00 $0.00 $0.00
TOTAL $19,585.35 $0.00 $0.00 $12,434.89 $7,150.46 $0.00 $0.00 $0.00 $0.00 $0.00
Payer: Managed Care - Humana HUM
BINKLEY, WILLIAM (BINKW) $14,941.00 $0.00 $0.00 $4,743.12 $10,197.88 $0.00 $0.00 $0.00 $0.00 $0.00
Houston, Mary (HOUSM) $1,611.89 $0.00 $0.00 $0.00 $1,611.89 $0.00 $0.00 $0.00 $0.00 $0.00
TOTAL $16,552.89 $0.00 $0.00 $4,743.12 $11,809.77 $0.00 $0.00 $0.00 $0.00 $0.00