Page 218 - 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 # 4
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
Kemp, MARION (KEMPM) $167.07 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $167.07
Krolak, Donald (KROL D) $365.56 $0.00 $0.00 $0.00 $0.00 $161.35 $161.35 $42.86 $0.00 $0.00
Palmer, Bertha (PALMB) $111.56 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $111.56
TOTAL $1,237.60 $0.00 $0.00 $34.51 $239.01 $224.10 $215.87 $94.51 $150.97 $278.63
Payer: Medicare B Coins from Private MBP
MITCHELL, JAMES (MITCJ) $362.15 $0.00 $0.00 $3.42 $217.39 $141.34 $0.00 $0.00 $0.00 $0.00
TOTAL $362.15 $0.00 $0.00 $3.42 $217.39 $141.34 $0.00 $0.00 $0.00 $0.00
Payer: Private Pay PP
Beane, Jo Nell (BEANJ) $495.00 $0.00 $0.00 $0.00 $495.00 $0.00 $0.00 $0.00 $0.00 $0.00
Bell, Elsie (BELL E) $0.14 $0.00 $0.00 $0.00 $0.09 $0.05 $0.00 $0.00 $0.00 $0.00
Kemp, MARION (KEMPM) $14,715.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $3,630.00 $11,085.00
Noel, Peggy (NOEL) ($6,045.00) $0.00 ($1,095.00) ($4,950.00) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
SCOTT, CHARLES (SCOTC) $1,342.96 $0.00 $0.00 $0.00 $1,107.20 $235.76 $0.00 $0.00 $0.00 $0.00
Wright, Mary (WRIGM) $19,506.23 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $4,785.00 $14,721.23
TOTAL $30,014.33 $0.00 ($1,095.00) ($4,950.00) $1,602.29 $235.81 $0.00 $0.00 $8,415.00 $25,806.23
Payer: Resident Liability PL
Beane, Jo Nell (BEANJ) $1,841.40 $0.00 $753.30 $837.00 $251.10 $0.00 $0.00 $0.00 $0.00 $0.00
Bell, Virginia (BELLV) $1,368.78 $0.00 $1,060.80 $307.98 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
BERKLEY, TREVA (BERKT) $0.08 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.08
Brunzel, Sandra (BRUN S) $581.00 $0.00 ($50.00) $0.00 $631.00 $0.00 $0.00 $0.00 $0.00 $0.00
Conaway, Harvey (CONAH) ($549.00) $0.00 $0.00 $0.00 $0.00 $0.00 ($81.40) ($467.64) $0.00 $0.04
Erwin, Wanda (ERWI W) $0.00 $0.00 $0.00 $0.00 $6.00 ($6.00) $0.00 $0.00 $0.00 $0.00
Estes, Brenda (ESTEB) ($149.25) ($149.24) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ($0.01)
Fitzgerald, Thomas (FITZ T) ($316.60) $0.00 ($316.60) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Flanary, Dolores (FLAND) ($28.63) $0.00 ($6.00) ($6.00) ($6.00) ($6.00) ($4.71) $0.00 $0.00 $0.08
Jeter, Daisy (JETED) $0.14 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.02 $0.12
Moon, Clara (MOON C) ($752.40) $0.00 ($752.40) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Palmer, Bertha (PALMB) ($364.36) $0.00 $0.00 ($1,117.36) $753.00 $0.00 $0.00 $0.00 $0.00 $0.00
Smith, Billy (BSMITH) ($0.12) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ($0.02) ($0.10) $0.00
Sykes, Helen (SYKE H) ($4,877.88) $0.00 $0.00 $0.00 $0.00 ($4,394.36) ($483.52) $0.00 $0.00 $0.00
Sykes, Martha (SYKE) $819.82 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $819.82
Wright, Mary (WRIGM) $2,737.57 $0.00 $1,057.00 $1,057.00 $623.57 $0.00 $0.00 $0.00 $0.00 $0.00
TOTAL $310.55 ($149.24) $1,746.10 $1,078.62 $2,258.67 ($4,406.36) ($569.63) ($467.66) ($0.08) $820.13
Payer: UnitedHealthCare MCO UMC
BERKLEY, TREVA (BERKT) $17,612.96 $0.00 $0.00 $0.00 $4,320.10 $4,491.07 $4,491.07 $4,310.80 $0.00 ($0.08)
Boothe, Debra (BOOTD) $10,457.69 $0.00 $5,129.10 $180.27 $5,129.10 $9.61 $9.61 $0.00 $0.00 $0.00