Pulse check: reduce discharged not final billed

Does your organization struggle with getting bills out the door within a timely manner? You are not alone. Many organizations have identified discharged not final billed (DNFB) as an opportunity within their organization for 2018. It is already difficult for providers to get reimbursed on time because of the ever-growing impact of denials. Learning how to reduce the time it takes to get a bill to the payer will help to streamline an organization’s reimbursement. However, many organizations struggle to reduce the impact DNFB has on reimbursement.

For instance, at one organization we looked at the top five unbilled discharge departments by both volume and total charges. What we uncovered was that the median age of the unbilled accounts was 30 days from time of discharge. This organization’s unbilled claims represented 8% of open A/R by volume and 18% of total open balances. Additionally, 60% of these unbilled balances were coming from just one facility. This presented the organization with a great opportunity to improve the way they address and review DNFB accounts.

Many organizations struggle with DNFB because there is not enough staff to handle the workload, there are process inefficiencies or just a lack of funds. Organizations need to obtain support from hospital leaders to drive improvements for different departments processes. In addition, leaders should look to develop and designate a task force to track and analyze DNFB root causes. The task force should consist of hospital leaders (e.g., CFO, CMO), clinical representatives (e.g., Case Management, VP of Nursing), and revenue cycle leadership (e.g., Patient Access, HIM, PFS). While uncovering the root cause, the task force should assign a code to each DNFB account that corresponds to departments in order to prioritize improvement strategies. Utilizing this proven strategy will allow providers to reduce their DNFB. One organization was able to reduce DNFB dollars by 43% ($7M) after an organization-wide focus on DNFB, which included the launch of a DNFB task force.

Building the business case to focus on DNFB will allow your organization to reduce DNFB dollars and get reimbursed more quickly. Driving more revenue for the organization will allow you to focus on additional goals and initiatives.