Coding, Classification & Reimbursement

1.  DNFB

Posted 19 days ago
​​Hello,

If your hospital calculates DNFB, what patient types are included?
Do you include the physician office un-coded visits in your hospital DNFB?
Do you maintain a separate DNFB for your physician offices?
If you don't use DNFB as a measurement for your physician offices, what measurement do you use?

It has been suggested at my hospital that we include our physician office visits in our hospital DNFB.  This doesn't make much sense to me but wondered if other hospitals are doing the same thing or if you are using a different measurement.

Thank you for your help!

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Renee Meunier
Director, HIM and Privacy Officer
DeKalb Health
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2.  RE: DNFB

Posted 19 days ago
​Hospital and physician office DNFB are completely separate at my organization. Honestly I have never worked for any place that has combined them. I personally think it would skew your numbers tremendously because you do not get a true picture of each entity and the unbilled.

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Courtney Burbach
Executive Director HIM, Privacy Officer
Faith Regional Health Services
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3.  RE: DNFB

Posted 19 days ago
We include everything but also split it out by sections in our report so people can see outpatient vs. ED vs. inpatient, etc.

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Seth Katz
Associate Administrator, Information Management
Truman Medical Center
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4.  RE: DNFB

Posted 19 days ago

There should be a very specific definition between DNFB and DNFC.  DNFC (Discharge – not final coded) is a component of DNFB.  What should be counted in your DNFC are any and all accounts that require diagnosis/procedure coding.  In DNFC there should be differentiation of the type of accounts comprising the DNFC as well as the payment type as commonly Blue Cross and Medicare pay faster, and that is of high interest to PFS.  It is also important to track why the accounts are in DNFC – is it a coding delay or a documentation delay?  If a documentation delay – identify the physicians.  The CDI program can also affect the DNFC, so identifying the reasons the accounts are not final coded is very important.






5.  RE: DNFB

Posted 18 days ago
Usually the DNFB is calculated by total patients regardless where they are seen or where they received services.  It is up to tbe facility to determine how they want to calculate it.

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[Iris] [Martinez, RHIA, CCS, CDIP]
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6.  RE: DNFB

Posted 18 days ago
​As you can see from the responses, there is not a "one size fits all" for DNFB calcuations.  Usually for a CFO, any and all accounts/departments are included as they all are holding up cash flow.  At our facility, the physician billing is a totally separate entity so we do not include those accounts in our DNFB calculations.

What I have found useful, as others suggest, is to go ahead and prepare the DNFB as a whole as requested.  Then breakdown the DNFB by reason (coding, authorization, insurance, etc).  Then also break it down by responsible area (hospital, clinic, etc) so that everyone can see how their area is impacted.

Jan


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Janice Wiens
Director, HIM
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