Page 217 - Financial Workbook November

Date: Dec 18, 2017 Towne Square Care of Puryear - SNF
Time: 16:40:42 CT A/R Aging by Service Date
User: Zach Bell November 2017 Page # 3
Resident Name (ID) Total Future Cash Current 30 60 90 120 150 180 210
+ 11/17 11/17 10/17 09/17 08/17 07/17 06/17 05/17 + 04/17

TOTAL $157,866.07 $0.00 $17,129.59 $30,873.46 $20,000.20 $14,088.72 $5,980.05 $11,923.98 $15,621.29 $42,248.78
Payer: Medicare A Coins from Insurance MAI
Curd, Russell (CURDR) $9,705.50 $0.00 $0.00 $0.00 $0.00 $0.00 $1,316.00 $4,935.00 $3,454.50 $0.00
TOTAL $9,705.50 $0.00 $0.00 $0.00 $0.00 $0.00 $1,316.00 $4,935.00 $3,454.50 $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 $0.00 $0.00 $0.00 $10,857.00
Flanary, Dolores (FLAND) $12,666.50 $0.00 $0.00 $0.00 $0.00 $0.00 $493.50 $3,125.50 $2,467.50 $6,580.00
Jeter, Daisy (JETED) $5,757.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $5,757.50
Palmer, Bertha (PALMB) $2,467.50 $0.00 $0.00 $2,467.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Smith, Martha (SMITHM) $12,173.00 $0.00 $0.00 $4,441.50 $4,935.00 $2,796.50 $0.00 $0.00 $0.00 $0.00
TOTAL $43,921.50 $0.00 $0.00 $6,909.00 $4,935.00 $2,796.50 $493.50 $3,125.50 $2,467.50 $23,194.50
Payer: Medicare B MCB
Beane, Jo Nell (BEANJ) $474.20 $0.00 $0.00 $99.22 $374.98 $0.00 $0.00 $0.00 $0.00 $0.00
Bell, Elsie (BELL E) $259.25 $0.00 $0.00 $0.00 $0.00 $45.57 $213.68 $0.00 $0.00 $0.00
Conaway, Harvey (CONAH) $794.34 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $202.52 $591.82 $0.00
Flanary, Dolores (FLAND) $798.68 $0.00 $0.00 $36.09 $562.11 $200.48 $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 $0.00 $0.00 $869.21
Krolak, Donald (KROL D) $1,432.97 $0.00 $0.00 $0.00 $0.00 $632.49 $632.49 $167.99 $0.00 $0.00
MITCHELL, JAMES (MITCJ) $1,419.77 $0.00 $0.00 $13.43 $852.21 $554.13 $0.00 $0.00 $0.00 $0.00
Moon, Clara (MOON C) $374.43 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $374.43 $0.00
Palmer, Bertha (PALMB) $437.30 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $437.30
SCOTT, CHARLES (SCOTC) $5,531.49 $0.00 $0.00 $0.00 $4,557.17 $974.32 $0.00 $0.00 $0.00 $0.00
Wright, Mary (WRIGM) $200.84 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $200.84
TOTAL $12,592.48 $0.00 $0.00 $148.74 $6,346.47 $2,406.99 $846.17 $370.51 $966.25 $1,507.35
Payer: Medicare B Coins from Insurance MBI
Kemp, MARION (KEMPM) $54.65 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $54.65
Moon, Clara (MOON C) $95.53 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $95.53 $0.00
TOTAL $150.18 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $95.53 $54.65
Payer: Medicare B Coins from Medicaid MBM
Beane, Jo Nell (BEANJ) $120.96 $0.00 $0.00 $25.32 $95.64 $0.00 $0.00 $0.00 $0.00 $0.00
Bell, Elsie (BELL E) $66.14 $0.00 $0.00 $0.00 $0.00 $11.62 $54.52 $0.00 $0.00 $0.00
Conaway, Harvey (CONAH) $202.62 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $51.65 $150.97 $0.00
Flanary, Dolores (FLAND) $203.69 $0.00 $0.00 $9.19 $143.37 $51.13 $0.00 $0.00 $0.00 $0.00