Don't Let DNFB Cripple Hospital Cash Flow

Dom Nicastro, for HealthLeaders Media , January 23, 2013

Staffing and technology
Be aware that a shortage of qualified, credentialed, and experienced coders can make your organization's DNFB rise. A lack of an adequate staff working seven days a week in the scanning, analysis, and coding areas could mean higher rates, Gryzbowski warns. 

"ICD-10 may make that shortage more severe and have a detrimental effect on DNFB," she says. "Electronic health records and a good electronic document management system that makes physician completion of record deficiencies easier to manage actually helps improved and decrease the DNFB rate."

Even when your organization is doing well preparing for audits like the CMS Recovery Audit Program, you may be hurting your DNFB.

"Some organizations are choosing to pre-bill review these types of accounts as a precautionary measure which leaves it on the report longer," Weidemann says. "External audits often post big risks for an organization, and no organization can afford to pay back audits for multiple accounts. Some organizations are choosing to be proactive in their audit activities and mitigate their risk by placing accounts on ‘hold' in order to review the documentation and code assignment internally before the account is dropped."

Dom Nicastro is a contributing writer. He edits the Medical Records Briefings newsletter and manages the HIPAA Update Blog.
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