Chiropractic Billing Performance Index - August 2006

August Billing Performance Index (BPI) underperformed July value by 8.7%, replacing six participants in the list of top ten performers and dropping the index from 15 down to 16.3. This article reports a third iteration of a prototype for a rule-based chiropractic billing index, including its coverage definition, update cycle, volume weighting, and provided information.

BPI = 16.3 means that the average of ten top performing payers working with BillingPrecision.com clients have 16.3% 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 16.3
• Blue Cross Blue Shield Texas 2.2
• Horizon 5
• CareFirst NCA 6.8
• Liberty Mutual 11.6
• United Health Care 11.6 (down from 5 in July)
• Oxford 15.4 (down from 5.7 in July)
• Medicare New Jersey 16.6 (down from 11.7 in July)
• Cigna 18.3 (down from 12.4 in July)
• Florida 1st 23.7
• Medicare Wisconsin 42

Dropped participants from July BPI:

• Medicare West Virginia 1.1
• Medicare Virginia 10.5
• Medicare Alabama 11.9
• Aetna 13
• Blue Cross Blue Shield New Jersey 15.7
• Blue Cross Blue Shield Alabama 23.9

Improved participants with respect to July BPI: None.

Underperforming participants with respect to July BPI:

• United Health Care 11.6 (down from 5 in July)
• Oxford 15.4 (down from 5.7 in July)
• Medicare New Jersey 16.6 (down from 11.7 in July)
• Cigna 18.3 (down from 12.4 in July)

New participants with respect to July BPI:

• Blue Cross Blue Shield Texas 2.2
• Horizon 5
• CareFirst NCA 6.8
• Liberty Mutual 11.6
• Florida 1st 23.7
• Medicare Wisconsin 42

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.