Q: How often should we generate and monitor the discharge not final billed (DNFB) report?
A: You should generate the DNFB report at least weekly. Generating the report daily is ideal. This report lists all encounters for patients who have been discharged but not billed. It includes all discharged accounts that have not been billed, so some accounts on the list may require coding, charge entry, or attention by patient financial services.
Coding managers should work with patient financial services and the information technology department to refine the DNFB list so it includes only cases that require the coding department’s attention. Managers can then focus on ensuring that coders address the oldest accounts first. Otherwise billing may be delayed and the timely billing deadline missed.
Some organizations bill self-pay accounts or accounts not billed to an insurer without codes. These accounts may not appear on the DNFB list. However, if the account changes to an insurer-covered account, it will then appear on the list. These accounts require particular attention because they may be close to the untimely filing deadline.
Accounts on the DNFB list sometimes have a zero or negative balance; these require investigation. A zero balance account typically indicates an account number that was assigned but to which no charges were posted. Often, these are accounts assigned at the time of preregistration, but the patients never arrived to receive services. Coding managers should report these situations to patient financial services and ask members of the department to do what is necessary so they no longer appear on the DNFB list.
Accounts with negative balances may result when:
- Payments are applied to the wrong account
- Too many charges are removed from an account and applied elsewhere
- Excessive copayments are collected
Ask patient financial services when it usually processes credit balances and be attentive to them. They may signal an account that is missing a service code.
Editor’s note: This Q&A is adapted from HCPro’sCoding Manager’s Handbook.
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