Fillable Printable Cash Receipts Journal Example Template
Fillable Printable Cash Receipts Journal Example Template
Cash Receipts Journal Example Template
Effective July 1, 2006
Louisiana State University Health Care Services Division
Cash Receipts Journal Entry Template
Operating Funds - Fund 111
Page 1
cash-receipts-journal-example-03.xls
Index Business Unit DATE Line # Account Fund DeptID Program Class Amount
1 7/1/2006 1 110207 111 2081001 95001 61010 DEBIT
7/1/2006 2 491901 111 2100001 95001 61010 CREDIT
Collection of Cash and Recognition of Maternal and Child Health Revenue
2 7/1/2006 1 110207 111 2081001 95001 61010 DEBIT
7/1/2006 2 490119 111 2100001 95001 61010 CREDIT
Collection of Cash and Recognition of Maternal and Child Health Indirect Cost
3 7/1/2006 1 110207 111 2084150 95001 61010 DEBIT
7/1/2006 2 464250 111 2067150 95001 61010 CREDIT
Collection of Cash and Recognition of Other Income - Pathology services billed outside of the patient accounting system.
4 7/1/2006 1 110207 111 2084280 95001 61010 DEBIT
7/1/2006 2 464250 111 2067280 95001 61010 CREDIT
5 7/1/2006 1 110207 111 2084340 95001 61010 DEBIT
7/1/2006 2 464215 111 2067340 95001 61010 CREDIT
6 7/1/2006 1 110207 111 2084341 95001 61010 DEBIT
7/1/2006 2 464250 111 2067342 95001 61010 CREDIT
Collection of Cash and Recognition of Pharmacy processing fees
7 7/1/2006 1 110207 111 2084342 95001 61010
7/1/2006 2 464250 111 2067342 95001 61010
8 7/1/2006 1 110207 111 2084950 95001 61010 DEBIT
7/1/2006 2 491901 111 2047950 95001 61010 CREDIT
Collection of Cash and Recognition of WIC Revenues - Other Income
Collection of Cash and Recognition of revenue for services provided to Veterans Administration and billed outside of the patient accounting
system.
Collection of Cash and Recognition of Rebates. NOTE: All rebates should be coded to this revenue account regardless of when
received. Rebates should not be classified as Return of Appropriation.
Collection of Cash and Recognition of other outpatient retail pharmacy sales, such as employee prescriptions, pharmacy coupon program and
Medicare Part D (except for Medicaid, which should be coded to cash department 2085102) .
Effective July 1, 2006
Louisiana State University Health Care Services Division
Cash Receipts Journal Entry Template
Operating Funds - Fund 111
Page 2
cash-receipts-journal-example-03.xls
Index Business Unit DATE Line # Account Fund DeptID Program Class Amount
9 7/1/2006 1 110207 111 2084960 95001 61010 DEBIT
7/1/2006 2 491901 111 2047930 95001 61010 CREDIT
10 7/1/2006 1 110207 111 2084961 95001 61010 DEBIT
7/1/2006 2 491901 111 Varies 95001 61010 CREDIT
11 7/1/2006 1 110207 111 2084961 95001 61010 DEBIT
7/1/2006 2 490119 111 2018711* 95001 61010 CREDIT
Collection of Cash for any Indirect Cost recovered for an Sponsored Project assigned to Fund 111
*Or department specific to the sponsored project
12 7/1/2006 1 110207 111 2084962 95001 61010 DEBIT
7/1/2006 2 491901 111 2047930 95001 61010 CREDIT
13 7/1/2006 1 110207 111 2084963 95001 61010 DEBIT
7/1/2006 2 491901 111 2047930 95001 61010 CREDIT
14 7/1/2006 1 110207 111 2085001 95001 61010 DEBIT
7/1/2006 2 464250 111 Varies 95001 61010 CREDIT
Collection of Cash and Recognition of Miscellaneous IAT Revenues
15 7/1/2006 1 110207 111 2085020 95001 61010 DEBIT
7/1/2006 2 464265 111 2018710 95001 61010 CREDIT
Collection of Cash and Recognition of State General Fund Receipts
16 7/1/2006 1 110207 111 2085030 95001 61010 DEBIT
7/1/2006 2 464250 111 Varies 95001 61010 CREDIT
Collection of Cash and Recognition of OPH Ryan White (IAT) Revenues - Title II ADAP
Collection of Cash for Miscellaneous Sponsored Project assigned to Fund 111. For Revenue Department, use 210XXX department assigned
for specific Sponsored Project (such as 2100008 for Breast & Cervical Cancer Program); if no department assigned, use miscellaneous
sponsored projects department 2100014.
Collection of Cash and Recognition of OPH Ryan White Title III (Federal - Direct) Revenues- (Only for MCLNO; for all other hospitals
with RWTIII, LSUHSC-NO is the grantee, see instructions for Fund 115)
Collection of Cash and Recognition of OPH Ryan White Title I (Self-Generated - Local) Revenues
Effective July 1, 2006
Louisiana State University Health Care Services Division
Cash Receipts Journal Entry Template
Operating Funds - Fund 111
Page 3
cash-receipts-journal-example-03.xls
Index Business Unit DATE Line # Account Fund DeptID Program Class Amount
Collection of Cash -- Used as a Deposit Clearing Department *Contact Cash Management for Instructions
Effective July 1, 2006
Louisiana State University Health Care Services Division
Cash Receipts Journal Entry Template
Operating Funds - Fund 111
Page 4
cash-receipts-journal-example-03.xls
Index Business Unit DATE Line # Account Fund DeptID Program Class Amount
17 7/1/2006 1 110207 111 2085060 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Collection of Cash and Recognition of Medicare Acute Receipts
18 7/1/2006 1 110207 111 2085065 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Collection of Cash and Recognition of Medicare -Professional Fees (physician, CRNA, nurse practitioner, physician assistant) Receipts
19 7/1/2006 1 110207 111 2085070 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Collection of Cash and Recognition of Medicaid Acute Receipts
20 7/1/2006 1 110207 111 2085075 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Collection of Cash and Recognition of Medicaid - Professional Fees (physician, CRNA, nurse practitioner, physician assistant) Receipts
21 7/1/2006 1 110207 111 2085083 95001 61010 DEBIT
7/1/2006 2 113750 111 CREDIT
Collection of Cash or Payment and Recognition of Medicare Cost Report Settlements
22 7/1/2006 1 110207 111 2085084 95001 61010 DEBIT
7/1/2006 2 464300 111 2095900 95001 61010 CREDIT
Collection of Cash and Recognition of Medicare Pass Thru (Contractual) Receipts
23 7/1/2006 1 110207 111 2085087 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Collection of Cash and Recognition of Medicare - Rehabilitation Receipts
24 7/1/2006 1 110207 111 2085089 95001 61010 DEBIT
7/1/2006 2 * 111 * 95001 61010 CREDIT
Collection of Cash and Recognition for Medicare - Other Receipts *Contact Cash Management for instructions
25 7/1/2006 1 110207 111 2085092 95001 61010 DEBIT
7/1/2006 2 464400 2095900 95001 61010 CREDIT
Effective July 1, 2006
Louisiana State University Health Care Services Division
Cash Receipts Journal Entry Template
Operating Funds - Fund 111
Page 5
cash-receipts-journal-example-03.xls
Index Business Unit DATE Line # Account Fund DeptID Program Class Amount
Collection of Cash and Recognition of Medicaid Uncompensated Care Cost Receipts
Effective July 1, 2006
Louisiana State University Health Care Services Division
Cash Receipts Journal Entry Template
Operating Funds - Fund 111
Page 6
cash-receipts-journal-example-03.xls
Index Business Unit DATE Line # Account Fund DeptID Program Class Amount
26 7/1/2006 1 110207 111 2085093 95001 61010 DEBIT
7/1/2006 2 113750 111 CREDIT
Collection of Cash or Payment and Recognition of Medicaid Cost Report Settlements
27 7/1/2006 1 110207 111 2085097 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Collection of Cash and Recognition of Medicaid - Rehabilitation Receipts
28 7/1/2006 1 110207 111 2085099 95001 61010 DEBIT
7/1/2006 2 * 111 * 95001 61010 CREDIT
Collection of Cash and Recognition for Medicaid - Other Receipts *Contact Cash Management for instructions
29 7/1/2006 1 110207 111 2085100 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Collection of Cash and Recognition of Medicaid - Kid Med Receipts
30 7/1/2006 1 110207 111 2085102 95001 61010 DEBIT
7/1/2006 2 464250 111 2067340 95001 61010 CREDIT
Collection of Cash and Recognition of Medicaid - Pharmacy Receipts
31 7/1/2006 1 110207 111 2085150 95001 61010 DEBIT
7/1/2006 2 464250 111 2058150 95001 61010 CREDIT
Collection of Cash and Recognition of Fees for Medical Assistance Program (MAP)
32 7/1/2006 1 110207 111 2085120 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Collection of Cash and Recognition of Medicare - Psych Receipts
33 7/1/2006 1 110207 111 2085130 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Collection of Cash and Recognition of Medicaid - Psych Receipts
34 7/1/2006 1 110207 111 2085206 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Effective July 1, 2006
Louisiana State University Health Care Services Division
Cash Receipts Journal Entry Template
Operating Funds - Fund 111
Page 7
cash-receipts-journal-example-03.xls
Index Business Unit DATE Line # Account Fund DeptID Program Class Amount
Collection of Cash and Recognition of Commerical Acute Receipts
Effective July 1, 2006
Louisiana State University Health Care Services Division
Cash Receipts Journal Entry Template
Operating Funds - Fund 111
Page 8
cash-receipts-journal-example-03.xls
Index Business Unit DATE Line # Account Fund DeptID Program Class Amount
35 7/1/2006 1 110207 111 2085207 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Collection of Cash and Recognition of Commerical Professional Fees (physician, CRNA, nurse practitioner, physician assistant) Receipts
36 7/1/2006 1 110207 111 2085208 95001 61010 DEBIT
7/1/2006 2 464310 111 2095920 95001 61010 CREDIT
Collection of Cash or Payment and Recognition of Tricare Settlements
37 7/1/2006 1 110207 111 2085216 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Collection of Cash and Recognition of Self-Pay Acute Receipts
38 7/1/2006 1 110207 111 2085217 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Collection of Cash and Recognition of Self-Pay Professional Fees (physician, CRNA, nurse practitioner, physician assistant) Receipts
39 7/1/2006 1 110207 111 2085220 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Collection of Cash and Recognition of Self-Generated Psych Receipts
40 7/1/2006 1 110207 111 2085230 95001 61010 DEBIT
7/1/2006 2 464138 111 2095920 95001 61010 CREDIT
Collection of Cash and Recognition of Prisoner Care Receipts
41 7/1/2006 1 110207 111 2085250 95001 61010 DEBIT
7/1/2006 2 464250 111 Varies 95001 61010 CREDIT
42 7/1/2006 1 110207 111 2085290 95001 61010 DEBIT
7/1/2006 2 464180 111 2068290 95001 61010 CREDIT
Collection of Cash and Recognition of Revenue for Medical Record Fees
Collection of Cash and Recognition of Miscellaneous Revenue. Inform HCSDA of any significant recurring miscellaneous revenue; a
new department may need to be established. Miscellaneous Sponsored Projects should be classified to Cash Department 2084961
(See # 10 above). Sponsored Projects include services/programs/activities underwritten by an external organization.
Effective July 1, 2006
Louisiana State University Health Care Services Division
Cash Receipts Journal Entry Template
Operating Funds - Fund 111
Page 9
cash-receipts-journal-example-03.xls
Index Business Unit DATE Line # Account Fund DeptID Program Class Amount
43 7/1/2006 1 110207 111 2085330 95001 61010 DEBIT
7/1/2006 2 464250 111 2068330 95001 61010 CREDIT
44 7/1/2006 1 110207 111 2085340 95001 61010 DEBIT
7/1/2006 2 464195 111 2059150 95001 61010 CREDIT
Collection of Cash and Recognition of Revenue for Parking Fines
45 7/1/2006 1 110207 111 2085350 95001 61010 DEBIT
7/1/2006 2 464185 111 2058870 95001 61010 CREDIT
Collection of Cash and Recognition of Telephone Pay Phone Commission Revenue
46 7/1/2006 1 110207 111 2085370 95001 61010 DEBIT
7/1/2006 2 464190 111 2059150 95001 61010 CREDIT
47 7/1/2006 1 110207 111 2085390 95001 61010 DEBIT
7/1/2006 2 464150 111 2068390 95001 61010 CREDIT
Collection of Cash and Recognition of Guest and Employee Meals Revenue
48 7/1/2006 1 110207 111 2085400 95001 61010 DEBIT
7/1/2006 2 464235 111 2078820 95001 61010 CREDIT
Collection of Cash and Recognition of Garnishment Fees
49 7/1/2006 1 110207 111 2085420 95001 61010 DEBIT
7/1/2006 2 464210 111 2018710 95001 61010 CREDIT
Collection of Cash and Recognition of ID Card Replacement Fees
50 7/1/2006 1 110207 111 2085650 95001 61010 DEBIT
7/1/2006 2 223080 111 CREDIT
Collection of Cash and Recognition of Liability for Seed Advance.
Collection of Cash and Recognition of Revenue for Social Services Department. Note: Pharmacy Processing Fees should be
classified per item 6 regardless of department completing applications.
Collection of Cash for Rental Income. Note: rental of state properties requires Office of Facility Planning & Control approval. Proceeds
may have to be forwarded to OFPC.
Effective July 1, 2006
Louisiana State University Health Care Services Division
Cash Receipts Journal Entry Template
Operating Funds - Fund 111
Page 10
cash-receipts-journal-example-03.xls
Index Business Unit DATE Line # Account Fund DeptID Program Class Amount
51 7/1/2006 1 110207 111 2085701 or 2 95001 61010 DEBIT
7/1/2006 2 461280 111 2018711 95001 61010 CREDIT
Transfer of Cash and Recognition of Transfer to Reflect Poolings between Business Units - Interagency Transfers
52 7/1/2006 1 110207 111 2085580 95001 61010 DEBIT
7/1/2006 2 464155 111 Varies 95001 61010 CREDIT
Collection of Cash for Repayment of Nursing Stipends
53 7/1/2006 1 110207 111 2085630 95001 61010 DEBIT
7/1/2006 2 464165 111 2067250 95001 61010 CREDIT
Collection of Cash and Recognition of Tuition Revenue - Radiology
NOTE: Refunds and Credits should be classified to Return of Appropriation utilizing original coding used when the purchase was made. If original coding is
unknown, contact Cash Management for instructions.
Effective July 1, 2006
Louisiana State University Health Care Services Division
Cash Receipts Journal Entry Template
Restricted Funds
Page 11
cash-receipts-journal-example-03.xls
Index DATE Line # Account Fund DeptID Program Class Project Amount
1 07/01/06 1 110207 115 2084961 95001 61010 XXXXXXX DEBIT
07/01/06 2 491901 115 XXXXXX 95001 61010 XXXXXXX CREDIT
Collection of Cash and Recognition of Other Sponsored Projects Revenues assigned to a Fund 115 Project
2 07/01/06 1 110207 115 2084961 95001 61010 XXXXXXX DEBIT
07/01/06 2 490119 115 2018711 95001 61010 XXXXXXX CREDIT
Collection of Cash and Recognition of F & A Payment (Indirect Costs) for Sponsored Projects assigned to a Fund 115 Project
3 07/01/06 1 110207 111 DEBIT
07/01/06 2 5XXXXX 111 XXXXXX 95001 61010 CREDIT
07/01/06 1 110207 113* XXXXXXX DEBIT
07/01/06 2 5XXXXX 113* XXXXXX 95001 61010 XXXXXXX CREDIT
To move expenditures from Fund 111 to Fund 113, 115 or 116
* Use the same template for Funds 115 and 116
4 07/01/06 1 110207 115 2084962 95001 61010 XXXXXXX DEBIT
07/01/06 2 491901 115 XXXXXX 95001 61010 XXXXXXX CREDIT
Business
Unit
Collection of Cash and Recognition of Reimbursement from LSUHSC regardless of the year of receipt. No longer are
receipts from LSUHSC received in the same fiscal year as the expense, to be classified as Return of Appropriation
