The following table is a static reproduction of the revenue tab from the interactive budget-planning workbook. This version was developed based on a set of assumptions, indicated by the numbers entered in the shaded cells.
Download the Excel file so that you can change the numbers, as necessary, to estimate revenue for your clinic.
Interactive Budget-Planning Workbook—Revenue
(This table is static, the downloadable workbook is interactive.)
REVENUE Insert program-specific estimates in highlighted cells |
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I. Patient-Care Revenue—estimated number of encounters/year | 4,940 | |||||||
Fee-for-service | % of encounters | # of encounters | Avg charge/ encounter | Total charges |
Average adjustment/ encounter |
Total charge reductions |
Adjusted charge/ encounter | Amount billed |
Medicaid | 45% | 2,223 | $285 | $633,555 | $30 | $66,690 | $172 | $382,356 |
CHIP | 8% | 395 | $285 | $112,632 | $100 | $39,520 | $185 | $73,112 |
Public and private-nonprofit program contracts | 4% | 198 | $285 | $56,316 | $140 | $27,664 | $145 | $28,652 |
Self-Pay | ||||||||
Full | 3% | 148 | $285 | $42,237 | $- | $- | $285 | $42,237 |
Sliding fee schedule | 11% | 543 | $285 | $154,869 | $200 | $108,680 | $85 | $46,189 |
Minimum | 15% | 741 | $285 | $211,185 | $240 | $177,840 | $45 | $33,345 |
Commercial insurance | ||||||||
Indemnity (fee-for-service) | 5% | 247 | $285 | $70,395 | $- | $- | $285 | $70,395 |
Managed Care - PPO | 3% | 148 | $285 | $42,237 | $65 | $9,633 | $220 | $32,604 |
Fee-for-servic patient-care revenue subtotal | $1,323,426 | $430,027 | $708,890 | |||||
Medicaid prospective payment or cost-based (fee/encounter) | 0% | 0 | $0 | |||||
Capitation/Managed Care (HMO) - (List individual numbers and capitation rates if multiple contracts, whether commercial or Medicaid HMOs) | # of patients | Capitation rate | Total charges |
Adjustment per patient | Total charge reductions |
$/patient/yr | ||
Dental plan | 6% | 296 | 360 | $106,704 | 180 | 53,230 | $180 | $53,352 |
0 | $0 | |||||||
0 | $0 | |||||||
0 | $0 | |||||||
Capitation Patient-Care Revenue Subtotal | $53,352 | |||||||
PATIENT-CARE REVENUE TOTAL | $762,242 | |||||||
II. Non-Patient-Care Revenue Sources | ||||||||
A. Grants and contracts | ||||||||
Federal | $100,000 | |||||||
State | $50,000 | |||||||
City/County | $20,000 | |||||||
Foundation(s) | $75,000 | |||||||
Other | ||||||||
Grants and contracts subtotal | $245,000 | |||||||
B. Fundraising | ||||||||
Individual donations | $10,000 | |||||||
Corporate donations | $19,000 | |||||||
Events | $7,500 | |||||||
Other | ||||||||
Fundraising Subtotal | $36,500 | |||||||
NON-PATIENT-CARE REVENUE TOTAL | $281,500 | |||||||
REVENUE (ALL SOURCES) | $1,043,742 |