Chiropractic Billing Performance Index 2007 - Ten Best-Paying Insurance Companies
By Yuval Lirov 
The annual Billing Precision Index (BPI) reflects payer performance stability over time. BPI 2007 shows a different payer ranking from its 2006 prototype. The first place is now confidently held by Blue Cross Blue Shield Illinois (replacing United Healthcare) for its participation in every one of the monthly BPI indexes during 2007. Its performance is especially impressive in comparison to the seventh place BCBS IL held in 2006. Additionally, BPI 2007 has Medicare New Jersey and Cigna switching the second and the third places, while improving Aetna's position from fifth to fourth place.
In contrast to the monthly BPI, which lists ten best paying insurance companies for chiropractic CPT codes in the past month selected according to multiple criteria, e.g., minimal processed claim volume, the annual BPI simply counts the frequency of the payer participation in the monthly BPI of the previous year. While showing a low percent of accounts receivable beyond 120 days is critical to be included in the billing index, the frequency of participation in the index is a more robust performance metric as it also serves to measure billing performance consistency over longer time period.
The table below lists the insurance companies that made the listing of BPI 2007 along with their average billing index and the range as it appeared during 2007.
Twelve times
- Blue Cross Blue Shield Illinois: 10.9, [7.1, 16]
Eleven times:
- Cigna: 13.4, [8.9, 24.1]
- Medicare New Jersey: 15.7, [7.5 to 20.5]
Ten times:
- Aetna: 16.6, [8.8, 22.1]
- United Healthcare: 17.2, [11.3, 23.2]
Seven times:
- Medicare Illinois: 14, [5.8, 30.4]
- Blue Cross Blue Shield New Jersey: 18, [13.9, 24.3]
- Blue Cross Blue Shield Pennsylvania: 23.5, [12.4, 43.4]
Five times:
- Blue Cross Blue Shield Georgia: 34.1, [22.9, 43.3]
Four times:
- Blue Cross Blue Shield South Carolina: 19.1, [12.4, 34.1]
Three times:
- Blue Cross Blue Shield Michigan: 6.8, [3.2, 13.6]
- Blue Cross Blue Shield Texas: 15.2, [10.3, 20]
- GEICO: 34.93, [33.4, 36.2]
Twice:
- Blue Cross Blue Shield Colorado: 9.6, [6.8, 12.3]
- Humana: 9.9, [7.9, 11.8]
- Medicare Wisconsin: 29.4, [29.1, 29.7]
Once:
- PHCS: 0.3
- QualCare: 0.9
- Atlantic Administrators: 1.2
- Unicare: 9.6
- Principal Life Insurance: 10.6
- GHI: 11.5
- CBSA: 12.4
- Medicaid Pennsylvania: 5.1
- Assurant: 15.4
- Blue Cross Blue Shield Alabama: 21.3
- Great West: 22
- Medicare Pennsylvania: 23.1
- Medicaid Illinois: 36.7
Coverage
Monthly BPI is rule-based, i.e., payer participation in the index is defined by a set of dynamic rules at the time of computation, rather than a static listing of specific payers. Therefore, any specific payer may start or discontinue participation in the index, dependent on satisfaction of the rule's conditions. The current selection of payers for participation in the BPI is based on one hundred top-volume providers and all payers across all United States that have processed more than six hundred claims through Billing Precision services.
Update Cycle
Billing Precision updates BPI on a monthly basis. In order to accommodate future growth of provided information, index combinations, and sensitivity across multiple indices, the Billing Precision Index employs Volume Weighting.
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
Chiropractic office managers use the rule-based index to benchmark their billing performance and guide its improvement over time. Note that a simple comparison of a payer's performance metric to a national benchmark determines if that payer performs well, or not. The rule-based approach to benchmarking also allows ranking of an entire set of payers by sorting them according to the same performance metric. Rule-based benchmarking also allows for the identification of elite payers, those that perform best in comparison to every payer in the country, as shown by the index-driven ranking. Finally, since the billing index stands for the entire set of such select participants, the number of times a given payer has participated in the monthly index determines its performance stability.
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