Page 199 - Financial Workbook July

Date: Aug 25, 2017 Towne Square Care of Puryear - SNF
Time: 15:01:58 CT A/R Aging by Service Date
User: Zach Bell August 2017 Page # 2
Resident Name (ID) Total Future Cash Current 30 60 90 120 150 180 210
+ 08/17 08/17 07/17 06/17 05/17 04/17 03/17 02/17 + 01/17

TOTAL $91,457.67 $0.00 $17,023.84 $16,150.23 $13,295.08 $15,618.81 $12,357.86 $10,295.27 $6,716.58 $0.00
Payer: Medicaid Pending MP
Prince, Cathy (PRINC) $28,902.00 $0.00 $5,115.00 $4,102.00 $4,950.00 $5,115.00 $4,950.00 $4,670.00 $0.00 $0.00
Wright, Mary (WRIGM) $16,849.14 $0.00 $5,115.00 $5,115.00 $4,950.00 $1,669.14 $0.00 $0.00 $0.00 $0.00
TOTAL $45,751.14 $0.00 $10,230.00 $9,217.00 $9,900.00 $6,784.14 $4,950.00 $4,670.00 $0.00 $0.00
Payer: Medicare A MCA
BERKLEY, TREVA (BERKT) $8,918.72 $0.00 $0.00 $0.00 $0.00 $0.00 $945.93 $4,189.09 $3,783.70 $0.00
Conaway, Harvey (CONAH) $3,908.89 $0.00 $0.00 $0.00 $749.97 $3,158.92 $0.00 $0.00 $0.00 $0.00
Curd, Russell (CURDR) $25,821.21 $0.00 $0.00 $2,760.31 $8,343.40 $10,435.39 $4,282.11 $0.00 $0.00 $0.00
Flanary, Dolores (FLAND) $19,069.43 $0.00 $0.00 $637.36 $2,830.61 $2,026.98 $4,053.97 $9,520.51 $0.00 $0.00
Jeter, Daisy (JETED) $7,531.93 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1,206.74 $6,325.19 $0.00
Smith, Martha (SMITHM) $11,284.49 $0.00 $8,702.11 $2,582.38 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Wright, Mary (WRIGM) $7,941.54 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $404.32 $7,537.22 $0.00
TOTAL $84,476.21 $0.00 $8,702.11 $5,980.05 $11,923.98 $15,621.29 $9,282.01 $15,320.66 $17,646.11 $0.00
Payer: Medicare A Coins from Insurance MAI
Curd, Russell (CURDR) $9,705.50 $0.00 $0.00 $1,316.00 $4,935.00 $3,454.50 $0.00 $0.00 $0.00 $0.00

TOTAL $9,705.50 $0.00 $0.00 $1,316.00 $4,935.00 $3,454.50 $0.00 $0.00 $0.00 $0.00
Payer: Medicare A Coins from Medicaid MAM
BERKLEY, TREVA (BERKT) $10,857.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1,151.50 $5,099.50 $4,606.00 $0.00
Flanary, Dolores (FLAND) $12,666.50 $0.00 $0.00 $493.50 $3,125.50 $2,467.50 $4,935.00 $1,645.00 $0.00 $0.00
Jeter, Daisy (JETED) $5,757.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1,151.50 $4,606.00 $0.00
TOTAL $29,281.00 $0.00 $0.00 $493.50 $3,125.50 $2,467.50 $6,086.50 $7,896.00 $9,212.00 $0.00
Payer: Medicare B MCB
Bell, Elsie (BELL E) $213.68 $0.00 $0.00 $213.68 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Conaway, Harvey (CONAH) $794.34 $0.00 $0.00 $0.00 $202.52 $591.82 $0.00 $0.00 $0.00 $0.00
Kemp, MARION (KEMPM) $869.21 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $214.25 $654.96 $0.00
Krolak, Donald (KROL D) $800.48 $0.00 $0.00 $632.49 $167.99 $0.00 $0.00 $0.00 $0.00 $0.00
Moon, Clara (MOON C) $374.43 $0.00 $0.00 $0.00 $0.00 $374.43 $0.00 $0.00 $0.00 $0.00
Palmer, Bertha (PALMB) $437.30 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $437.30 $0.00
Wright, Mary (WRIGM) $200.84 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $200.84 $0.00 $0.00
TOTAL $3,690.28 $0.00 $0.00 $846.17 $370.51 $966.25 $0.00 $415.09 $1,092.26 $0.00