Medical Billing Performance Index

Benchmark-driven performance management helpsdiscontinue participation in the index, dependent on
establish objective industry standards. Medical servicesatisfaction of rule's conditions.Current selection of
providers can use benchmarking to evaluatepayers for participation in the BPI is based on fifty
performance of their billing service and measure theirtop-volume providers across all United States that
improvement over time. This article presents ahave received Billing Precision services for more than
prototype for a rule-based chiropractic index, includingsix months and have more than two hundred claims
its coverage definition, update cycle, volumein their current Accounts Receivable. Update Cycle
weighting, and provided information.Current (JuneBilling Precision updates its index on a monthly basis.
2006) Billing Precision Index (BPI) stands at 18, whichVolume Weighting BPI is volume weighted, which is
means that the average of ten top performingimportant to accomodate future growth of provided
payers working with BPI clients have 18% ofinformation, index combinations, and sensitivity across
Accounts Receivable beyond 120 days. This is a keymultiple indices. Information Provided BPI computes
billing performance characteristic, as it is a proxy ofthe percent of Accounts Receivable beyond 120
the claims that are never paid. Obviously, the lower isdays. Note that national average across all medical
the index the better is billing performance. The tablespecialties of percent of accounts receivable beyond
below also lists the top ten performing payers and120 days is 17.7%. Summary Medical Billing
their relative index as recorded in Billing Precision'sPerformance Index helps the development of billing
system ( ).industry standards. Medical service providers can use
the index to benchmark their billing performance and
Billing Precision Index 18to guide its improvement over time. Rule-based index
Benesight 5definition allows for automated inclusion and exclusion
Blue Cross Blue Shield Florida 5of payers in the index based on payer attributes,
Medicare Florida 7such as numbers of processed claims, accounts
United Health Care 8receivable distribution, certain mix of CPT codes, or
Oxford 11patient demographics. Relative payer index provides
Cigna 13billing process improvement direction.Yuval Lirov, PhD,
Medicare New Jersey 17author of "Mission Critical Systems Management"
Horizon 18(Prentice Hall, 1997), inventor of multiple patents in
Aetna 21artificial intelligence and computer security, and CEO
Blue Cross Blue Shield Texas 33of Billing Technologies. Vericle delivers comprehensive
Coverage BPI is rule-based, i.e., payer participation inpractice workflow engine that integrates patient
the index is defined by dynamically rules at the timescheduling, electronic medical records (EMR), billing,
of computation and not by a static listing of specifictranscription, and compliance management. It
payers. Therefore, any specific payer may start orimproves billing performance and reduces audit risk.