Quantity Used General Office Supplies (Pens, pencils, tape, clips, etc.) Letterhead and envelopes Letterhead Envelopes Computer paper Computer disks $1000.00/yr 5,000 each $15.00/500 $10.00/500 $20.00/box $25.00/box 40 boxes 10 boxes Service/Licens $500/yr Mobile file shelving service contract (payable January 1) $1500.00/yr Encoder software license (payable July 1) $.06/copy Reproduction/printing 30 pgs-60% of Medicare discharges and 20 pgs 20% of non-Medicare discharges lephone Service Telephone service Long-distance/fax charges $10.00/month/employee $800.00/yr ofessional Development $350.00 300 miles at 0.54/miles- S162.00 $90.00ight x 2 $180.00 Registration Travel Lodging State association annual mtg (1 person) $250.00 National seminar/ workshop Topic: TBD (1 person) Registration Travel $525.00 (Airfare-San Francisco) $120.00ight x 2 -$240.00 Lodging $110.00/each 300 miles at 0.54/miles = $162.00 $60.00/each Coding seminar (2 coders) Registration Travel Lodging Revenue The only revenue the department generates is in the release of information area. Historical data indicate revenue can be projected at an average of $10.00 per record. The volume is estimated at 50% Medicare discharges and 20% non-Medicare discharges. CURE-ALL MEDICAL CENTER SUMMARY BUDGET REQUEST FISCAL YEAR: Health Information Services DEPARTMENT: COST CENTER: 12100 INSTRUCTIONS: Present the total figures from your operating budget, capital expenditure budget, and personnel budget requests on this summary sheet and attach this page as the top sheet on your budget package when you submit it to your administrative head. REVENUE TOTAL EXPENSES BY CLASS 01 Supplies 02 Services 03 Other Expenses 04 Capital Equipment 05 Hourly Employees 06 Professional Employees 07 Fringe Benefits EXPENSE TOTAL Quantity Used General Office Supplies (Pens, pencils, tape, clips, etc.) Letterhead and envelopes Letterhead Envelopes Computer paper Computer disks $1000.00/yr 5,000 each $15.00/500 $10.00/500 $20.00/box $25.00/box 40 boxes 10 boxes Service/Licens $500/yr Mobile file shelving service contract (payable January 1) $1500.00/yr Encoder software license (payable July 1) $.06/copy Reproduction/printing 30 pgs-60% of Medicare discharges and 20 pgs 20% of non-Medicare discharges lephone Service Telephone service Long-distance/fax charges $10.00/month/employee $800.00/yr ofessional Development $350.00 300 miles at 0.54/miles- S162.00 $90.00ight x 2 $180.00 Registration Travel Lodging State association annual mtg (1 person) $250.00 National seminar/ workshop Topic: TBD (1 person) Registration Travel $525.00 (Airfare-San Francisco) $120.00ight x 2 -$240.00 Lodging $110.00/each 300 miles at 0.54/miles = $162.00 $60.00/each Coding seminar (2 coders) Registration Travel Lodging Revenue The only revenue the department generates is in the release of information area. Historical data indicate revenue can be projected at an average of $10.00 per record. The volume is estimated at 50% Medicare discharges and 20% non-Medicare discharges. CURE-ALL MEDICAL CENTER SUMMARY BUDGET REQUEST FISCAL YEAR: Health Information Services DEPARTMENT: COST CENTER: 12100 INSTRUCTIONS: Present the total figures from your operating budget, capital expenditure budget, and personnel budget requests on this summary sheet and attach this page as the top sheet on your budget package when you submit it to your administrative head. REVENUE TOTAL EXPENSES BY CLASS 01 Supplies 02 Services 03 Other Expenses 04 Capital Equipment 05 Hourly Employees 06 Professional Employees 07 Fringe Benefits EXPENSE TOTAL
