Outsourced Chiropractic Billing Service Performance Benchmark - September 2006

Yuval Lirov
 


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September Billing Performance Index (BPI) underperformed August value by 5.6%, replacing five participants in the list of top ten performers and dropping the index from 16.3 down to 21.9. This article describes a fourth iteration of a prototype for a rule-based chiropractic billing index, including its coverage definition, update cycle, volume weighting, and provided information.

BPI = 21.9 means that the average of ten top performing payers working with BillingPrecision.com clients have 21.9% 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 Billing Precision's system.

  • Billing Precision Index 21.9
  • Horizon 9.5 (down from 5 in August)
  • United Health Care 9.7 (up from 11.6 in August)
  • Medicare New Jersey 13.2 (up from 16.6 in August)
  • Blue Cross Blue Shield Illinois 14.8
  • Medicare Virginia 14.9
  • Cigna 18 (up from 18.3 in August)
  • Aetna 19.8
  • Blue Cross Blue Shield New Jersey 22.5
  • Medicare Wisconsin 23.4 (up from 42 in August)
  • Blue Cross Blue Shield Florida 55.5

Dropped participants from August BPI:

  • Blue Cross Blue Shield Texas 2.2
  • CareFirst NCA 6.8
  • Liberty Mutual 11.6
  • Oxford 15.4
  • Florida 1st 23.7

Improved participants with respect to August BPI:

  • United Health Care 9.7 (up from 11.6 in August)
  • Medicare New Jersey 13.2 (up from 16.6 in August)
  • Cigna 18 (up from 18.3 in August)
  • Medicare Wisconsin 23.4 (up from 42 in August)

Underperforming participant with respect to August BPI:

  • Horizon 9.5 (down from 5 in August)

New participants with respect to August BPI:

  • Blue Cross Blue Shield Illinois 14.8
  • Medicare Virginia 14.9
  • Aetna 19.8
  • Blue Cross Blue Shield New Jersey 22.5
  • Blue Cross Blue Shield Florida 55.5

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 accomodate 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.

Yuval Lirov, PhD, author of "Mission Critical Systems Management" (Prentice Hall), inventor of multiple patents in artificial intelligence and computer security, co-author of ChiroAudit.com, and CEO of Vericle.com Billing Technologies. Vericle® delivers comprehensive practice workflow engine that integrates patient scheduling, SOAP notes, billing, transcription, and compliance management. Chiropractic Audit webinar, prepared by BillingPrecision.com, teaches how to improve billing performance and reduce audit risk. Yuval invites you to register to the next webinar at ChiroAudit.com.

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