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Medical Billing Performance Index - July 2006

 

July Billing Precision Index (BPI) outperformed June value by 20%, replacing five participants in the list of top ten performers and bringing the index from 18 down to 15. This article reports a second iteration of a prototype for a rule-based chiropractic index, including its coverage definition, update cycle, volume weighting, and provided information.

BPI = 15 means that the average of ten top performing payers working with BillingPrecision.com clients have 15% 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 15
  • Medicare West Virginia 1.1
  • United Heath Care 5 (up from 8 in June)
  • Oxford 5.7 (up from 11 in June)
  • Medicare Virginia 10.5
  • Medicare New Jersey 11.7 (up from 17 in June)
  • Medicare Alabama 11.9
  • Cigna 12.4 (up from 13 in June)
  • Aetna 13 (up from 21 in June)
  • Blue Cross Blue Shield New Jersey 15.7
  • Blue Cross Blue Shield Alabama 23.9

Dropped participants from June BPI:

  • Benesight 5
  • Blue Cross Blue Shield Florida 5
  • Medicare Florida 7
  • Horizon 18
  • Blue Cross Blue Shield Texas 33

Improved participants with respect to June BPI:

  • United Health Care 8
  • Oxford 11
  • Cigna 13
  • Medicare New Jersey 17
  • Aetna 21

New participants with respect to June BPI:

  • Medicare West Virginia 1.1
  • Medicare Virginia 10.5
  • Medicare Alabama 11.9
  • Blue Cross Blue Shield New Jersey 15.7
  • Blue Cross Blue Shield Alabama 23.9

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 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, computed by BillingPrecision.com, 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.

Author: Yuval Lirov
 
Author Bio:

Yuval Lirov

Yuval Lirov, PhD, author of "Mission Critical Systems Management" (Prentice Hall, 1997), inventor of multiple patents in artificial intelligence and computer security, and CEO of Vericle. Vericle delivers comprehensive practice workflow engine that integrates patient scheduling, electronic medical records (EMR), billing, transcription, and compliance management. It improves billing performance and reduces audit risk. Yuval invites you to post questions about and share your knowledge of medical billing and compliance at BillingWiki.

 
 
 

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