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Just Other Articles - Outsourced Chiropractic Billing Service Performance Index - July 2006
July Billing Precision Index (BPI) outperformed BPI for June by 20%, replacing five participants in the list of top ten performers and bringing BPI from 18 down to 15. This article reports a se
According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product
cond iteration of a prototype for a rule-based chiropractic index, including its coverage definition, update cycle, volume weighting, and provided information.
BPI = 15 means that the average of t
BPI = 15 means that the average of t
; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.
Examples of combination products may in
Examples of combination products may in
n top performing payers working with BillingPrecision.com clients have 15% of Accounts Receivable beyond 120 days. BPI is a key billing performance characteristic, as it is a proxy of the claims t
lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.
hat 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 P
here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe
ecision's system.
- Billing Precision Index 15
- Medicare West Virginia 1.1
- United Heath Care 5 (up from 8 in
d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.
Combination pro
Combination pro
June)
Oxford 5.7 (up from 11 in June)
Medicare Virginia 10.5
Medicare New Jersey 11.7 (up from 17 in June) <
ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc
li>
Medicare Alabama 11.9
Cigna 12.4 (up from 13 in June)
Aetna 13 (up from 21 in June)
Blue Cross Blue Shield New Jersey 15.7
easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi
Dropped participants from June BPI:
- Benesight 5
- Blue Cross Blue Shield Florida 5
- Medicare Flo
nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically
ida 7
Horizon 18
Blue Cross Blue Shield Texas 33
Improved participants with respect to June BPI:
Improved participants with respect to June BPI:
and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ
ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi
17
Aetna 21
New participants with respect to June BPI:
New participants with respect to June BPI:
- Medicare West Virginia 1.1
- Medicare Virginia
ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.
Following aspects would a
Following aspects would a
10.5
Medicare Alabama 11.9
Blue Cross Blue Shield New Jersey 15.7
Blue Cross Blue Shield Alabama 23.9
Coverage
BPI is
Coverage
BPI is
dd to the challenges in developing combination products:
Which markets to tap where the combination products can do fairly well?
Which combination prod
Which markets to tap where the combination products can do fairly well?
Which combination prod
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 star
cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
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 a
Current selection of payers for participation in the BPI is based on fifty top-volume providers across a
tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
ll 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
BillingPr
Update Cycle
BillingPr
t?
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
cision.com updates BPI on a monthly basis.
Volume Weighting
BPI is volume weighted, which is important to accomodate future growth of provided information, index combinations, and sensit
Volume Weighting
BPI is volume weighted, which is important to accomodate future growth of provided information, index combinations, and sensit
ping new procedures for reviewing their safety, efficacy and quality.
Professional from academic institutions, pharmaceutical industries, health care indust
Professional from academic institutions, pharmaceutical industries, health care indust
ivity 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
Information Provided
BPI computes the percent of Accounts Receivable beyond 120 days. Note that national average across all medical specialties of percent
y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products
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 ind
Summary
Medical Billing Performance Index helps the development of billing industry standards. Medical service providers can use the ind
.
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
ex 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 att
elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.
Companies that provide selfless information through particip
Companies that provide selfless information through particip
ibutes, 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
tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products
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