(B) Revenue Sources and Grouping Revenue

Sources of health care revenue are often grouped by payer. Thus services might be grouped as follows:

Revenue from the Medicare Program (payer = Medicare)

Revenue from the Medicaid Program (payer = Medicaid)

Revenue from Blue Cross Blue Shield (payer = Commercial Insurance)

or

Revenue from Blue Cross Blue Shield (payer = Managed Care Contract)

The Metropolis Health System has revenue sources from operations, donations, and interest income. The revenue from operations is primarily received for services. MHS groups its revenue first by cost center. Within each cost center the services revenue is then grouped by payer.

1. A worksheet has been set up with individual columns across the top for six revenue sources (payers): Medicare, Medicaid, Other Public Programs, Patients, Commercial Insurance, and Managed Care Contracts

2. Certain situations concerning the Intensive Care Unit and the Laboratory are described below.

Six vertical line items have been set up on your worksheet, numbered (1) through (6). Six situations are described below. For each of the six situations, indicate its number (1 through 6) and enter the appropriate cost center (either Intensive Care Unit or Laboratory). Then place an X in the column(s) that represents the correct revenue source(s) for the item. The six situations are as follows:

(1) ICU stay billed to employees insurance program.

(2) Lab test paid for by an individual.

(3) Pathology work performed for the state.

(4) ICU stay billed to members health plan.

(5) ICU stay billed for Medicare beneficiary.

(6) Series of allergy tests run for eligible Medicaid beneficiary