Chiropractic Billing Service Precision Index-January


by Yuval Lirov - Date: 2007-02-06 - Word Count: 547 Share This!

January 2007 Billing Performance Index (BPI) underperformed December 2006 value by 2.3%, replacing four participants in the list of top ten performers and dropping the index from 13.1 down to 15.4. This article describes an 8-th iteration of a rule-based chiropractic billing index, including its coverage definition, update cycle, volume weighting, and provided information.

BPI = 15.4 means that the average of ten top performing payers working with Billing Precision clients have 15.4% of Accounts Receivable beyond 120 days. BPI is a key billing performance characteristic, as it is a proxy of the claims that are never paid. Obviously, the lower is the index the better is billing performance. The table below also lists the top ten performing payers and their relative index as recorded in the Billing Precision's system.

Billing Precision Index 15.4 Blue Cross Blue Shield Illinois 9.4 (up from 10.6 in December) Blue Cross Blue Shield Texas 10.3 Cigna 11.2 (up from 12 in December ) Blue Cross Blue Shield South Carolina 12.7 Medicare New Jersey 14 (up from 16.3 in December) Blue Cross Blue Shield New Jersey 16.9 (up from 18.5 in December) Aetna 18.3 United Health Care 19.2 (down from 7.1 in December) Medicare Illinois 25.9 Medicare Wisconsin 29.1 (down from 18.5 in December)

Dropped participants from December BPI: Triad 3.5 Blue Cross Blue Shield Wisconsin 4.4 Medicare Florida 5.6 Health EOS 11.9

Improved participants with respect to December BPI:

Blue Cross Blue Shield Illinois 9.4 (up from 10.6 in December) Cigna 11.2 (up from 12 in December ) Medicare New Jersey 14 (up from 16.3 in December) Blue Cross Blue Shield New Jersey 16.9 (up from 18.5 in December)

Underperforming participants with respect to December BPI:

United Health Care 19.2 (down from 7.1 in December) Medicare Illinois 25.9 Medicare Wisconsin 29.1 (down from 18.5 in December)

New participants with respect to December BPI:

Blue Cross Blue Shield Texas 10.3 Blue Cross Blue Shield South Carolina 12.7 Aetna 18.3 Medicare Illinois 25.9

Coverage

BPI is rule-based, i.e., payer participation in the index is defined by dynamically rules at the time of computation and not by a static listing of specific payers. Therefore, any specific payer may start or discontinue participation in the index, dependent on satisfaction of rule's conditions.

Current selection of payers for participation in the BPI is based on fifty top-volume providers across all United States that have received Billing Precision services for more than six months and have more than two hundred claims in their current Accounts Receivable.

Update Cycle

BillingPrecision.com updates BPI on a monthly basis.

Volume Weighting

BPI is volume weighted, which is important to accommodate future growth of provided information, index combinations, and sensitivity across multiple indices.

Information Provided

BPI computes the percent of Accounts Receivable beyond 120 days. Note that national average across all medical specialties of percent of accounts receivable beyond 120 days is 17.7%.

Summary

Medical Billing Performance Index helps the development of billing industry standards. Medical service providers can use the index to benchmark their billing performance and to guide its improvement over time. Rule-based index definition allows for automated inclusion and exclusion of payers in the index based on payer attributes, such as numbers of processed claims, accounts receivable distribution, certain mix of CPT codes, or patient demographics. Relative payer index provides billing process improvement direction.


Related Tags: soap, healthcare, audit, chiropractic, hipaa, cpt, icd, performance index, update cycle

Yuval Lirov, PhD, author of "Mission Critical Systems Management" (Prentice Hall), patent inventor in Artificial Intelligence and Computer Security, and CEO of Vericle.com Billing Technologies and Services. Download The "Business" of Healthcare Provider Audits - How Payers Are Getting Away with Practice Murder at ChiroAudit.com.

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