Finance Of Health Care

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PRO FORMA INC STMT

PRO FORMA INCOME STATEMENT
REVENUES:
Gross revenue $ - 0
Less contractual allowances $ - 0
Net patient revenue $ - 0
EXPENSES:
Salaries $ - 0
Benefits $ - 0
Medical supplies $ - 0
Radiopharmaceuticals $ - 0
Nuclear license $ - 0
Radiation safety consultant $ - 0
Radiation exposure monitoring $ - 0
First-year marketing expense $ - 0
Clinician education (one-time) $ - 0
Equipment insurance coverage $ - 0
Liability insurance coverage $ - 0
Patient education materials $ - 0
Interest expense $ - 0
Depreciation expense $ - 0
Bad debt expense $ - 0
Total Expenses $ - 0
Net Income Before Taxes $ - 0
INCOME TAXES:
Federal $ - 0
State $ - 0
Local $ - 0
Total Taxes $ - 0
Net Income After Taxes $ - 0

CONT MGN and BREAK-EVEN

PRO FORMA INCOME STATEMENT CONTRIBUTION MARGIN
BREAK-EVEN ANALYSIS
VOLUME - 0
REVENUES: PER EXAM TYPE OF EXP
Gross revenue $ - 0
Less contractual allowances $ - 0
Net patient revenue $ - 0 $ - 0 Net patient revenue per exam
VARIABLE EXPENSES:
Salaries $ - 0 $ - 0 0
Benefits $ - 0 $ - 0 0
Medical supplies $ - 0 $ - 0 0
Radiopharmaceuticals $ - 0 $ - 0 0
Patient education materials $ - 0 $ - 0 0
Bad debt expense $ - 0 $ - 0
Total Variable Expenses $ - 0 $ - 0 Total Variable Expense per exam
Contribution Margin $ - 0 $ - 0 Contribution Margin per exam
FIXED EXPENSES:
Nuclear license $ - 0 0
Radiation safety consultant $ - 0 0
Radiation exposure monitoring $ - 0 0
First-year marketing expense $ - 0 0
Clinician education (one-time) $ - 0 0
Equipment insurance coverage $ - 0 0
Liability insurance coverage $ - 0 0
Interest expense $ - 0 0
Depreciation expense $ - 0 0
Total Fixed Expenses $ - 0 $ - 0 Total Fixed Expenses
$ - 0 Contribution Margin per exam
- 0 BREAK-EVEN POINT
INCOME TAXES:
Federal $ - 0
State $ - 0
Local $ - 0
Total Taxes $ - 0
Net Income After Taxes $ - 0

INCOME TAX

INCOME TAXES: RATES AMOUNT
Federal $ - 0
State $ - 0
Local $ - 0
Total taxes 0% $ - 0

REVENUE

PAYOR % OF PATIENTS % OF MPFS BAD DEBT %
Medicare
Medicaid
Blue Cross/Blue Shield
Aetna
Cigna
United Healthcare
Other commercial
Workers' Comp
Self pay
Charity care
DESCRIPTION CPT CODE BALTO MD RATE
Radionuclide various $ 265.00 estimate per patient
Myocardial perfusion imaging; tomographic (SPECT), multiple studies (including attenuation correction when performed), at rest and/or stress (exercise and/or pharmacologic), and redistribution and/or rest injection, with or without quantification 78465 Use participating, non-facility price (with no modifiers)
Myocardial perfusion study with wall motion, qualitative or quantititative study (use in conjunction with 78460, 78461, 78464, 78465) 78478
Myocardial perfusion study with ejection fraction (use in conjunction with 78460, 78461, 78464, 78465) 78480
Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with physician supervision, with interpretation and report 93015
TOTAL MEDICARE FEE $ 265.00
GROSS CHARGE PER TEST
% OF PATIENTS NEEDING STRESS TEST
PHYSICIAN CASELOAD LOW MEDIUM HIGH
TOTAL ANNUAL TEST VOLUME
Physician caseload
# of cardiologists
% of patients needing stress testing
Annual anticipated test volume - 0
PAYOR VOLUME GROSS REVENUE NET FEE PER TEST CONTRACTUAL ALLOWANCE NET REVENUE BAD DEBT EXPENSE
Medicare - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0
Medicaid - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0
Blue Cross/Blue Shield - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0
Aetna - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0
Cigna - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0
United Healthcare - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0
Other commercial - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0
Workers' Comp - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0
Self pay - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0
Charity care - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0
TOTALS - 0 $ - 0 $ - 0 $ - 0 $ - 0

EXPENSES

PROJECTED VOLUME: - 0
STAFFING: AVG HR RATE HOURS/TEST TOTAL STAFF COUNT COST FTE
Physician $ - 0 - 0
Registered Nurse $ - 0 - 0
Respiratory Technician $ - 0 - 0
Nuclear Medicine Technician $ - 0 - 0
Receptionist $ - 0 - 0
Insurance verifier $ - 0 - 0
Biller $ - 0 - 0
Collector $ - 0 - 0
TOTAL - 0 $ - 0 - 0
Benefits as % of salary cost $ - 0
OPERATING EXPENSES: COST UNITS TYPE OF EXP
Salaries $ - 0
Benefits $ - 0
Routine medical supplies $ - 0
Radiopharmaceuticals $ - 0
Nuclear license $ - 0
Radiation safety consultant $ - 0
Radiation exposure monitors $ - 0
First-year marketing expense $ - 0
Clinician education (one-time) $ - 0
Equipment insurance coverage $ - 0
Liability insurance coverage $ - 0
Patient education materials $ - 0
Interest expense $ - 0
Depreciation $ - 0
TOTAL EXPENSES (not including bad debts) $ - 0
CAPITAL EXPENDITURES: COST USEFUL LIFE (YRS) DEPRECIATION
Dual-headed nuclear camera $ - 0
"Hot lab" renovations $ - 0
Additional plumbing $ - 0
Electrical & data cabling $ - 0
Treadmill, exam table, etc. $ - 0
Computer equipment $ - 0
Structural renovations $ - 0
$ - 0 $ - 0
FINANCING:
Borrow
Interest rate
Term in years