03/28/2007
3:27:47 PM

Xeni Medical Systems, Inc.
Provider Snap Shot report

 

 

MD Example PLLC

 

 

Submit Date: 02/01/2007 - 2/28/2007

 

 

Count

Billed

Fee Schedule

Expected

Loan

Payment Received

Loan Settled

Open Claims

 

115

 

162,765.00

 

45,341.91

 

12,382.81

 

613.06

 

0.00

 

0.00

 

CH Ack 

 

103

 

146,025.00

 

40,673.19

 

7,714.09

 

574.15

 

0.00

 

0.00

CH Rej 

 

12

 

16,740.00

 

4,668.72

 

4,668.72

 

38.91

 

0.00

 

0.00

No CH Status 

 

0

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

 

 

115

 

162,765.00

 

45,341.91

 

12,382.81

 

613.06

 

0.00

 

0.00

 

 

Closed Claims

 

148

 

231,915.00

 

64,807.92

 

35,143.93

 

4,011.30

 

47,850.52

 

4,011.30

 

Positive PMT 

 

104

 

141,265.00

 

39,477.38

 

28,986.08

 

2,503.43

 

47,850.52

 

2,503.43

Zero Dollar PMT 

 

44

 

90,650.00

 

25,330.54

 

6,157.85

 

1,507.87

 

0.00

 

1,507.87

 

 

 

148

 

231,915.00

 

64,807.92

 

35,143.93

 

4,011.30

 

47,850.52

 

4,011.30

 

 

Aged Off Claims

 

0

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

CH ACK/No PMT 

 

0

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

CH ACK/PMT 

 

0

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

CH REJ/No PMT 

 

0

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

CH REJ/PMT 

 

0

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

No CH STATUS/No PMT 

 

0

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

No CH STATUS/PMT 

 

0

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

 

0

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

 

Replaced/Retired Claims

 

  0

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

 

Total Submissions up to 2/28/2007

  263

 

394,680.00

 

110,149.83

 

47,526.74

 

4,624.36

 

47,850.52

 

4,011.30

 

Total Paid

 

  104

 

141,265.00

 

39,477.38

 

28,986.08

 

2,503.43

 

47,850.52

 

2,503.43

Total CH Reject

 

  12

 

16,740.00

 

4,668.72

 

4,668.72

 

38.91

 

0.00

 

0.00

Total Payer Reject (835)

 

  44

 

90,650.00

 

25,330.54

 

6,157.85

 

1,507.87

 

0.00

 

1,507.87

Total Open / Aged Off with Status

 

  103

 

146,025.00

 

40,673.19

 

7,714.09

 

574.15

 

0.00

 

0.00

Total Open / No Status

 

  0

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

Total Aged Off / No Status

 

  0

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

 

 

 263

 

394,680.00

 

110,149.83

 

47,526.74

 

4,624.36

 

47,850.52

 

4,011.30

 

 

Total problems:

 

  0

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00

 

0.00