Discharged Not Final Billed (DNFB) is an internal healthcare billing status. It describes patient accounts where an individual has been discharged from a facility, but the corresponding bill has not yet been fully processed and submitted for payment. DNFB serves as a tracking status, indicating that while patient care has concluded, the administrative steps required for billing are still underway.
Understanding Discharged Not Final Billed
Discharged Not Final Billed (DNFB) signifies a specific phase within the healthcare revenue cycle. This status indicates that a patient has left the hospital or clinic, but their medical record and the associated charges have not yet been fully compiled and sent to the payer, such as an insurance company or the patient directly. Hospitals use DNFB as an internal metric to monitor and manage the flow of patient accounts through their billing departments. This internal tracking helps healthcare organizations identify accounts that are awaiting completion of necessary documentation or coding. The DNFB status does not mean there is an issue with the patient’s care or that the patient has done something wrong. Instead, it reflects the detailed administrative work involved in converting medical services into a billable claim.
Common Reasons for Billing Delays
Several factors contribute to accounts being held in a Discharged Not Final Billed status, often stemming from administrative or clinical documentation requirements. One frequent cause involves incomplete clinical documentation, where physician notes, surgery reports, or discharge summaries may be missing or require further clarification. Accurate and comprehensive documentation is fundamental for precise medical coding, which directly impacts the final bill.
Coding discrepancies also frequently lead to billing delays. Medical coders translate healthcare services into standardized codes like CPT (Current Procedural Terminology) for procedures and ICD-10 (International Classification of Diseases, Tenth Revision) for diagnoses. If these codes are inaccurate, incomplete, or require additional details from the medical record, the bill cannot be finalized.
Other common reasons include issues with insurance verification or pre-authorization, which must be resolved before a claim can be submitted. Delays can also occur if physicians need to respond to queries for documentation clarification, or if test results are pending that are necessary for final coding.
Impact on Healthcare Operations
A significant volume of Discharged Not Final Billed accounts can affect a healthcare organization’s financial health and operational efficiency. When accounts remain in DNFB, the associated revenue is delayed, directly impacting the hospital’s cash flow. This delay means that money earned from services rendered is not immediately available for operational expenses, staff salaries, or investments in patient care.
Hospitals track DNFB as a key performance indicator (KPI) to assess the effectiveness of their revenue cycle management. High DNFB rates can signal inefficiencies in the billing process, potentially leading to increased days in accounts receivable (AR), which strains a hospital’s financial resources.
While DNFB is an internal tracking status, prolonged delays can indirectly affect when patients receive their final bills. The longer an account remains in DNFB, the longer it takes for the hospital to submit a claim to the insurer, which then delays the patient’s financial responsibility. Managing DNFB volume is important for financial stability and patient satisfaction.
From DNFB to Final Bill
Moving an account from Discharged Not Final Billed status to a finalized bill involves a coordinated internal process within a healthcare facility. Once all clinical documentation is complete and available, the medical record undergoes a thorough review. This review ensures all services, diagnoses, and procedures are accurately captured.
Following documentation review, professional medical coders apply the appropriate CPT and ICD-10 codes to all services performed. This step converts clinical information into billable data. The account then undergoes charge capture verification, ensuring all services and supplies are correctly itemized.
Finally, the claim undergoes a process known as “scrubbing,” where it is checked for any potential errors or inconsistencies that could lead to denials by payers. This helps ensure the claim is ready for submission. Most DNFB cases are resolved through these routine internal steps, allowing the bill to be sent to the payer without direct patient intervention.