Outsourced Chiropractic Billing Service Performance Benchmark - November 2006

November Billing Performance Index (BPI) outperformed October value by 30%, replacing one participant in the list of top ten performers and raising the index from 17.8 up to 13.7. This article describes a sixth iteration of a prototype for a rule-based chiropractic billing index, including its coverage definition, update cycle, volume weighting, and provided information.

BPI = 13.7 means that the average of ten top performing payers working with BillingPrecision.com clients have 13.7% 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 13.7
• Blue Cross Blue Shield Wisconsin 2.9 (up from 6.9 in October)
• Blue Cross Blue Shield Illinois 5.4 (up from 7.1 in October)
• Horizon 6.5 (down from 3.7 in October)
• Cigna 12 (up from 12.2 in October)
• United Health Care 12.1 (down from 11.7 in October)
• Medicare New Jersey 12.1 (down from 10.8 in October)
• Medicare Wisconsin 16.1 (up from 19.2 in October)
• Aetna 17.2 (up from 20.1 in October)
• Health EOS 19.5
• Blue Cross Blue Shield New Jersey 20.2 17.7 (down from 17.7 in October)

Dropped participant from October BPI:

• Blue Cross Blue Shield Florida 44.6

Improved participants with respect to October BPI:

• Blue Cross Blue Shield Wisconsin 2.9 (up from 6.9 in October)
• Blue Cross Blue Shield Illinois 5.4 (up from 7.1 in October)
• Cigna 12 (up from 12.2 in October)
• Medicare Wisconsin 16.1 (up from 19.2 in October)
• Aetna 17.2 (up from 20.1 in October)

Underperforming participant with respect to October BPI:

• Horizon 6.5 (down from 3.7 in October)
• United Health Care 12.1 (down from 11.7 in October)
• Medicare New Jersey 12.1 (down from 10.8 in October)

New participant with respect to October BPI:

• Health EOS 19.5

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 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.