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Hospitals and health systems that continuously monitor and respond to discharged-not-ftnal-billed (DNFB) metrics can speed cash flow and increase revenue, helping organizations remain nimble despite revenue cycle pressures.
In today's fast-paced healthcare environment, organizations cannot afford to have patient bills delayed for preventable reasons. Yet many hospitals and health systems struggle to keep their discharged-not-final-billed (DNFB) metrics-a measure of billing efficiency-in check.
The DNFB metric reflects all accounts where the patient has been discharged but the account has not left the patient-accounting system. Hospitals and health systems should be working to keep the time frame between discharge and billing as brief as possible, proactively addressing issues that could cause a bill or bills to hold. High DNFB can hurt cash flow because the slower an organization gets bills out the door, the slower it gets paid. In addition, organizations that focus on DNFB also can reduce delayed-filing denials, which can be very difficult to appeal.
Healthcare organizations always have some level of DNFB, of course, because the time between discharge and billing is not immediate. It can take several days for physicians and staff to perform post-discharge tasks such as completion of documentation, coding, and prebill auditing. "Best practice is to hold DNFB to three days or less, but the ability to achieve this target can vary depending on an organization's characteristics and patient population," says Sandra Wolfskill, director of healthcare finance policy, revenue cycle MAP, for HFMA.
Although containing DNFB is important, organizations also should ensure that their efforts do not result in faster billing at the expense of accuracy. If a bill goes out quickly but is incomplete or filled with mistakes, the cash flow advantages will be lost. Denials can actually increase if inaccurate bills are released to the payer.
Despite the advantages of streamlining DNFB, organizations can lose sight of this measure, missing the opportunity to improve efficiency and reduce delays. Following are some tips and strategies for bringing DNFB in line and enhancing the overall billing function.
Pull Together a Task Force
Optimizing DNFB should be a multidepartment project, because many different areas contribute to-and can slow-the billing process, including clinical documentation, health information management (HIM), utilization management, registration, and patient financial services. Bringing all stakeholders together to discuss...