<< Click to Display Table of Contents >> Navigation:  Report Dashboard > S-10 Worksheet Reports > Patient Payments S10 > Description and Usage

The Patient Payments S10 report is one of three reports used for gathering information for the S-10 worksheet to comply with CMS reporting mandates. This report will display patients who have the Charity Care and Collections screen filled out with a Charity Care Amount and there is a patient payment on the account within the reporting period.

 

This report will only display in a CSV format.

 

Listed below is an explanation of each column:

 

•Insurance Status (insurance_status): One of the following statuses will display:

▪Uninsured: This will pull for each line of a patient's account if the original financial class starts with a "P".

▪Insured: This will pull all other original financial classes.

 

•Primary Payor Plan (primary_payor): The name of the patient's primary insurance.

 

•Secondary Payor Plan (secondary_payor): The name of the patient's secondary insurance.

 

•Payment Transaction Code (last_transaction_code): The receipt code used when payment was posted to the patient's account.

 

NOTE: If a refund is posted to the patient's account, the Transaction Code will display "RF", and the refund amount will display as a negative amount in the Total Patient Payments for Services Provided column.

 

•Patient Identification Number (patient_identification_number): The patient's account number.

 

•Patient Name (patient_name): The patient's full name.

 

•Patient Birth Date (patient_birth_date): The patient's date of birth.

 

•Social Security Number (social_security_number): The patient's Social Security Number.

 

•Patient Gender (gender_desc): The patient's birth sex.

 

•Admit Date (admit_date): The patient's admit date.

 

•Discharge Date (discharge_date): The patient's discharge date.

 

•Service Indicator (service_indicator): Will display either "inpatient" or "Outpatient" depending on the stay type of the patient.

 

NOTE: Patient accounts will be considered inpatient if a "Y" is in the Census Reports column on page 4 of AHIS next to the stay type. Patients will be considered outpatient if an "N" is in the Census Reports column on page 4 of AHIS next to the stay type.

 

•Date of Collection (date_of_collection): The date of when the receipt was posted to the patient's account.

 

•Amount of Cash Collection (amount_of_cash_collection): The dollar amount of patient payments posted to the patient's account.

 

NOTE: The same patient may pull multiple times if there are multiple receipts within the reporting period.

 

•Total Hospital Charges for Services Provided (total_hosptial_charges): The total amount of charges, minus any physician charges and non-hospital charges, from the patient's account the payment was applied to.

 

•Total Physician/Professional Charges for Service Provided (physician_charges): The total amount of physician charges from the patent's account the payment was applied to.

 

•Date of Original Write-Off to Charity Care Contractual (date_of_orig_write_off_to_charity_care): Pulls the date in the Determination/Charity Care Write Off field in the Charity Care and Collections screen.

 

•Cost Report Year Claimed (cost_report_year_claimed_s10): Pulls the date in the Charity Care S10 Year Claimed field in the Charity Care and Collections screen.

 

•Patient Liability on Claim (patient_liability_total): The total coinsurance + copay + deductible + noncovered charges, from all insurance receipts on the patient's account.

 

•Bad Debt Amounts Written Off (write_of_total): The bad debt write off amount on the patient's account.

 

NOTE: This field will look to bad debt item numbers charged to patient accounts with a summary code of "WO".