| Benchmark-driven performance management helps | | | | participation in the index is defined by |
| establish objective industry standards. | | | | dynamically rules at the time of computation |
| Medical service providers can use | | | | and not by a static listing of specific |
| benchmarking to evaluate performance of their | | | | payers. Therefore, any specific payer may |
| billing service and measure their improvement | | | | start or discontinue participation in the |
| over time. This article presents a prototype | | | | index, dependent on satisfaction of rule's |
| for a rule-based chiropractic index, | | | | conditions.Current selection of payers for |
| including its coverage definition, update | | | | participation in the BPI is based on fifty |
| cycle, volume weighting, and provided | | | | top-volume providers across all United States |
| information.Current (June 2006) Billing | | | | that have received Billing Precision services |
| Precision Index (BPI) stands at 18, which | | | | for more than six months and have more than |
| means that the average of ten top performing | | | | two hundred claims in their current Accounts |
| payers working with BPI clients have 18% of | | | | Receivable. Update Cycle Billing Precision |
| Accounts Receivable beyond 120 days. This is | | | | updates its index on a monthly basis. Volume |
| a key billing performance characteristic, as | | | | Weighting BPI is volume weighted, which is |
| it is a proxy of the claims that are never | | | | important to accomodate future growth of |
| paid. Obviously, the lower is the index the | | | | provided information, index combinations, and |
| better is billing performance. The table | | | | sensitivity across multiple indices. |
| below also lists the top ten performing | | | | Information Provided BPI computes the percent |
| payers and their relative index as recorded | | | | of Accounts Receivable beyond 120 days. Note |
| in Billing Precision's system ( ). | | | | 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 |
| Billing Precision Index 18 | | | | development of billing industry standards. |
| | | | Medical service providers can use the index |
| Benesight 5 | | | | to benchmark their billing performance and to |
| | | | guide its improvement over time. Rule-based |
| | | | index definition allows for automated |
| Blue Cross Blue Shield Florida 5 | | | | inclusion and exclusion of payers in the |
| | | | index based on payer attributes, such as |
| Medicare Florida 7 | | | | numbers of processed claims, accounts |
| | | | receivable distribution, certain mix of CPT |
| United Health Care 8 | | | | codes, or patient demographics. Relative |
| | | | payer index provides billing process |
| Oxford 11 | | | | improvement direction.Yuval Lirov, PhD, |
| | | | author of "Mission Critical Systems |
| Cigna 13 | | | | Management" (Prentice Hall, 1997), inventor |
| | | | of multiple patents in artificial |
| Medicare New Jersey 17 | | | | intelligence and computer security, and CEO |
| | | | of Billing Technologies. Vericle delivers |
| Horizon 18 | | | | comprehensive practice workflow engine that |
| | | | integrates patient scheduling, electronic |
| Aetna 21 | | | | medical records (EMR), billing, |
| | | | transcription, and compliance management. It |
| Blue Cross Blue Shield Texas 33 | | | | improves billing performance and reduces |
| | | | audit risk. |
| Coverage BPI is rule-based, i.e., payer | | | | |