Don't Let DNFB Cripple Hospital Cash Flow

Dom Nicastro, for HealthLeaders Media , January 23, 2013

Success keys
"In some cases, the record is outstanding due to other reasons, such as a problem with a duplicate account number, or there is a question regarding a charge error," Grzybowski adds. "Whatever the reason, it should be classified in a category and not lumped together for one sum number. The HIM department should work in conjunction with the business office to agree on a method of classifying, tracking, and reporting this data on a regular basis to the C-Suite."

How else can healthcare leaders ensure their DNFB rates improve? Gryzbowski says leaders can start by:

  • Investing in an HIM operational assessment to identify causes of DNFB and possible solutions
  • Putting an ongoing tracking mechanism in place to monitor DNFB
  • Ensuring the Patient Financial Services (PFS) department and HIM teams agree how DNFB will be defined and measured
  • Enforcing record-completion policies
  • Ensuring that deficiency analysis takes place before coding (within the first 24 hours post discharge) to identify missing data earlier in the lifecycle of record processing, and to improve coder productivity to avoid them spending time searching for missing information

"Those facilities that have undergone a thorough HIM and Revenue Cycle operational assessment can identify the areas that need improvement," Gryzbowski adds. "And by implementing various changes in process, adjusting staffing, or providing better analytical tracking of the DNFB, problems can be avoided with the proper solutions."

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