Medical Billing Performance Index

Benchmark-driven performance managementsatisfaction of rule's conditions.Current selection of
helps establish objective industry standards.payers for participation in the BPI is based on fifty
Medical service providers can use benchmarkingtop-volume providers across all United States that
to evaluate performance of their billing servicehave received Billing Precision services for more
and measure their improvement over time. Thisthan six months and have more than two
article presents a prototype for a rule-basedhundred claims in their current Accounts
chiropractic index, including its coverage definition,Receivable. Update Cycle Billing Precision updates
update cycle, volume weighting, and providedits index on a monthly basis. Volume Weighting
information.Current (June 2006) Billing PrecisionBPI is volume weighted, which is important to
Index (BPI) stands at 18, which means that theaccomodate future growth of provided
average of ten top performing payers workinginformation, index combinations, and sensitivity
with BPI clients have 18% of Accounts Receivableacross multiple indices. Information Provided BPI
beyond 120 days. This is a key billing performancecomputes the percent of Accounts Receivable
characteristic, as it is a proxy of the claims thatbeyond 120 days. Note that national average
are never paid. Obviously, the lower is the indexacross all medical specialties of percent of
the better is billing performance. The table belowaccounts receivable beyond 120 days is 17.7%.
also lists the top ten performing payers and theirSummary Medical Billing Performance Index helps
relative index as recorded in Billing Precision'sthe development of billing industry standards.
system ( ).Medical service providers can use the index to
benchmark their billing performance and to guide
Billing Precision Index 18its improvement over time. Rule-based index
Benesight 5definition allows for automated inclusion and
Blue Cross Blue Shield Florida 5exclusion of payers in the index based on payer
Medicare Florida 7attributes, such as numbers of processed claims,
United Health Care 8accounts receivable distribution, certain mix of
Oxford 11CPT codes, or patient demographics. Relative
Cigna 13payer index provides billing process improvement
Medicare New Jersey 17direction.Yuval Lirov, PhD, author of "Mission
Horizon 18Critical Systems Management" (Prentice Hall,
Aetna 211997), inventor of multiple patents in artificial
Blue Cross Blue Shield Texas 33intelligence and computer security, and CEO of
Coverage BPI is rule-based, i.e., payerBilling Technologies. Vericle delivers comprehensive
participation in the index is defined by dynamicallypractice workflow engine that integrates patient
rules at the time of computation and not by ascheduling, electronic medical records (EMR), billing,
static listing of specific payers. Therefore, anytranscription, and compliance management. It
specific payer may start or discontinueimproves billing performance and reduces audit
participation in the index, dependent onrisk.