Agency:
(Part A) Acute Inpatients (including Sub Acute Program) / Bed Days for Which Fees were Raised / Fees Raised Including Adjustments$’000s / Less Bad Debts Expense
$’000s / Net Fee Income
$’000s
Orange highlight = new or modified item / a / b / c / d
Category
1 / Shared—Acute / =b1 -c1
2 / Shared—Sub Acute / =b2 -c2
3 / Single—Acute / =b3 -c3
4 / Single— Sub Acute / =b4 -c4
5 / Same Day—Acute / =b5 -c5
6 / Same Day— Sub Acute / =b6 -c6
7 / Work Cover Authority—Acute / =b7 -c7
8 / Work Cover Authority—Sub Acute / =b8 -c8
TAC and Other Compensable—Acute
TAC and Other Compensable—Sub Acute
9 / TAC - Acute / =b9 -c9
10 / TAC – Sub Acute / =b10 -c10
11 / Other Compensable—Acute / =b11 -c11
12 / Other Compensable—Sub Acute / =b12 -c12
13 / Nursing Home Type / =b13 -c13
14 / Palliative Care / =b14 -c14
15 / Prosthesis / =b15 -c15
16 / Other (includes ineligible) / =b16 -c16
17 / Mental Health / =b17-c17
18 / Other / =b18-c18
19 / Sub Total Acute/Sub Acute (=1+...+16) / =a1+…+a16 / =b1+…+b16 / =c1+…+c16 / =d1+…+d16
20 / Total (=17+18+19) / =a17+a18+a19 / =b17+b18+b19 / =c17+c18+c19 / =d17+d18+d19
Note: Please ensure:
(a) The total value of items 1 to 15 (Fee Raised Including Adjustments) ties with Patient and Resident Fees Raised - Acute Inpatients (consolidated) in Note xx: Patient and Resident Fees in the 2008-2009 Annual Financial Statement. (See Note 2b, Notes to and Forming Part of the Financial Statements of Health Services Annual Reporting Guidelines 2008-2009)
(b) The total value of item 16 (Fee Raised Including Adjustments) ties with Patient and Resident Fees Raised – Acute Other (consolidated) in Note xx: Patient and Resident Fees in the 2008-2009 Annual Financial Statement. (See Note 2b, Notes to and Forming Part of the Financial Statements of Health Services Annual Reporting Guidelines 2008-2009)
(c) The total value of item 17 (Fee Raised Including Adjustments) ties with Patient and Resident Fees Raised – Mental Health (consolidated) in Note xx: Patient and Resident Fees in the 2008-2009 Annual Financial Statement. (See Note 2b, Notes to and Forming Part of the Financial Statements of Health Services Annual Reporting Guidelines 2008-2009)
(d) The total value of item 18 (Fee Raised Including Adjustments) ties with Patient and Resident Fees Raised – Other (consolidated) in Note xx: Patient and Resident Fees in the 2008-2009 Annual Financial Statement. (See Note 2b, Notes to and Forming Part of the Financial Statements of Health Services Annual Reporting Guidelines 2008-2009)
(Part B) Acute Non-Admitted Patient Revenue / Amount$’000
e
1 / Prosthesis - compensable patients
2 / Prosthesis - ineligible patients
3 / Prosthesis - other
4 / Consulting Services - compensable patients
5 / Consulting Services - ineligible patients
6 / Consulting Services - other
7 / PBS payments
8 / Other outpatient fees
9 / Total (=1 to 8) / =e1+…+e8
(e) The total value of item 5 ties with Patient and Resident Fees Raised – Acute – Outpatients (consolidated) in Note xx: Patient and Resident Fees in the 2008-2009 Annual Financial Statement. (See Note 2b, Notes to and Forming Part of the Financial Statements of Health Services Annual Reporting Guidelines 2008-2009)
Agency Information Management System Form 4A / Effective 1 July 2009