| Benchmark-driven performance management | | | | satisfaction 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 benchmarking | | | | top-volume providers across all United States that |
| to evaluate performance of their billing service | | | | have received Billing Precision services for more |
| and measure their improvement over time. This | | | | than six months and have more than two |
| article presents a prototype for a rule-based | | | | hundred claims in their current Accounts |
| chiropractic index, including its coverage definition, | | | | Receivable. Update Cycle Billing Precision updates |
| update cycle, volume weighting, and provided | | | | its index on a monthly basis. Volume Weighting |
| information.Current (June 2006) Billing Precision | | | | BPI is volume weighted, which is important to |
| Index (BPI) stands at 18, which means that the | | | | accomodate future growth of provided |
| average of ten top performing payers working | | | | information, index combinations, and sensitivity |
| with BPI clients have 18% of Accounts Receivable | | | | across multiple indices. Information Provided BPI |
| beyond 120 days. This is a key billing performance | | | | computes the percent of Accounts Receivable |
| characteristic, as it is a proxy of the claims that | | | | beyond 120 days. Note that national average |
| are never paid. Obviously, the lower is the index | | | | across all medical specialties of percent of |
| the better is billing performance. The table below | | | | accounts receivable beyond 120 days is 17.7%. |
| also lists the top ten performing payers and their | | | | Summary Medical Billing Performance Index helps |
| relative index as recorded in Billing Precision's | | | | the development of billing industry standards. |
| system ( ). | | | | Medical service providers can use the index to |
| | | | benchmark their billing performance and to guide |
| Billing Precision Index 18 | | | | its improvement over time. Rule-based index |
| Benesight 5 | | | | definition allows for automated inclusion and |
| Blue Cross Blue Shield Florida 5 | | | | exclusion of payers in the index based on payer |
| Medicare Florida 7 | | | | attributes, such as numbers of processed claims, |
| United Health Care 8 | | | | accounts receivable distribution, certain mix of |
| Oxford 11 | | | | CPT codes, or patient demographics. Relative |
| Cigna 13 | | | | payer index provides billing process improvement |
| Medicare New Jersey 17 | | | | direction.Yuval Lirov, PhD, author of "Mission |
| Horizon 18 | | | | Critical Systems Management" (Prentice Hall, |
| Aetna 21 | | | | 1997), inventor of multiple patents in artificial |
| Blue Cross Blue Shield Texas 33 | | | | intelligence and computer security, and CEO of |
| Coverage BPI is rule-based, i.e., payer | | | | Billing Technologies. Vericle delivers comprehensive |
| participation in the index is defined by dynamically | | | | practice workflow engine that integrates patient |
| rules at the time of computation and not by a | | | | scheduling, electronic medical records (EMR), billing, |
| static listing of specific payers. Therefore, any | | | | transcription, and compliance management. It |
| specific payer may start or discontinue | | | | improves billing performance and reduces audit |
| participation in the index, dependent on | | | | risk. |