Don't Let DNFB Cripple Hospital Cash Flow

Dom Nicastro, for HealthLeaders Media , January 23, 2013

Healthcare leaders who know their financial data points understand there's one business metric that should never be on the upswing: discharged not final billed (DNFB). If an organization's bills don't leave the front door, its cash flow and opportunities to earn interest certainly will.

The C-Suite must set acceptable DNFB standards that are consistent in their measurement and organizational-specific issues, says Lou Ann Weidemann, MS, RHIA, CPEHR, FAHIMA, director of HIM Solutions at the American Health Information Management Association (AHIMA) in Chicago.

What can make DNFB rise?

  • Lack of qualified coders.
  • Bills held up during pre-bill audit reviews.
  • Poor internal review systems between the departments that code records and the clinicians who complete pathology and operative reports.

Most organizations set a three-day threshold for accounts, she says, meaning that accounts that are not coded or dropped within three days of discharge appear on the DNFB. Other organizations choose to keep the DNFB at a percentage of overall revenue (e.g. 2%) as their measurement. 

"Choose the measure that best fits the organization and stick with it," Weidemann says.

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