Reducing DNFB Rates with Health Information Management Software

Health information management (HIM) software with embedded analytics modules is in use by health systems with dozens of beds and hundreds of physicians. They report an improvement in Discharged Not Final Billed (DNFB) rates, which means more efficient payment collection after discharging patients. In some cases, this improvement results in an additional $1 million in annual reimbursement for the provided patient care. What are the steps that healthcare organizations have to take to achieve such impressive results?

If healthcare systems utilize analytical software to identify and eliminate incomplete bills, they will improve DNFB rates and reduce outstanding patient bills. This strategy protects them from non-compliance with the national average benchmarks in particular metrics, for example, in the surgical capture rate of the patients with comorbidities.

However, the absence of relevant analytical tools consequently leads to difficulties in achieving goals for DNFB improvements and reaching targeted benchmarks.

Challenges on the Way to Improved DNFB

Healthcare organizations continuously undergo a lack of working strategies to improve their financial performance, manage costs, and increase revenue. In their efforts to achieve those targets, hospital CEOs may decide on redundancies or cutting operating costs. Those measures might bring the feeling of effectiveness. 

However, they will eventually affect staff motivation and morale and negatively influence patient experience. That is why it is essential for healthcare providers to implement analytical tools that will be able to cope with the following tasks:

• Examining the opportunities that bring maximum contribution to achieving financial KPI and further concentration on the determined areas
• Identifying and managing DNFB cases where the reasons for incomplete bills are coding issues or inaccurate or insufficient documentation
• Advancing the accuracy of documentation, leading to improvements in the case mix index (CMI). It’s a metric that allows providers to assess the costliness of each particular case relevantly on the basis of the diagnosis, severity of the symptoms, and required resources. As a result, hospitals will count on adequate levels of reimbursement
• Decreasing the quantity of bills that have not been finalized and therefore cutting accounts receivable (AR) days
• Setting priorities based on analytics software and achieving benchmarks in the targeted areas, such as decreasing documentation gaps 
• Ensuring the time and resources allocated to improvements pay off and sustaining the achieved results 
• Results reporting and visibility to continuously track the performance in order to avoid losing the achieved outcomes.

Features of HIM Software to Bring More DNFB Dollars

To achieve the aim of increasing DNFB rates and tackling the above-mentioned challenges, healthcare systems rely on analytical software. With the help of it, organizations do the following:

• Access the required data promptly and easily, and indicate the exact areas where the issues occur 
• Use patient clinical, financial, insurance claims, and operation data on one platform
• Improve physician documentation and reduce the number of outstanding bills and AR days
• Analyze the documentation and applying accurate coding 
• Review the data of the surgery patients and identify if they have comorbidities and whether their accounts were accurately coded
• Manage the accounts of the discharged patients, for whom the billing has not yet been finalized and define the reason for delays 
• Monitor and sustain the positive trends in the DNFB rates, workflows for doctors and coders, and AR days 
• Eliminate manual work and embed the DNFB data into internal hospital environments such as dashboards and workflows.

Organizational Measures to Implement DNFB Analytics

Health systems need to take some organizational measures before and in the process of implementing new software. It will help to make the process smooth and seamless.

• Hospital executives should invest relevantly in the resources and analytics required for improving the DNFB rates
• It is recommended for hospital CEOs to cooperate with physicians to guarantee medical documentation is recorded more accurately and reflects each patient’s health condition
• It is recommended for financial executives to provide their office managers with access to the software. They could find incomplete documentation and instantly discuss those cases with physicians. Without such functionality, it takes coders some days to notify physicians about such issues.

What Benefits to Expect from Using DNFB Analytics?

Health information management software provides healthcare systems with aggregated data that they use to analyze the reasons for high DNFB rates and make efforts to improve the situation. Applying the analytical tool, as reported, brings providers the following enhanced results:

• Extra annual reimbursement for the appropriate level of provided care thanks to more precise clinical documentation and improved CMI
• Significant decrease in the number of outstanding accounts 
• A considerable reduction in the DNFB dollars, which positively influences the cash flow
• Significant reduction in the portion of the physician DNFB dollars
• Jumping on opportunity not only to achieve increased performance but also to sustain the results, for example, in reducing AR days. 

How Belitsoft Can Help

Belitsoft is a full-cycle software development and analytics consulting company that specializes in healthcare software development. We help top healthcare data analytics companies build robust data analytics platforms.

For integrated data platforms developed to collect, store, process, and analyze large volumes of data from various sources (Electronic Medical Records, clinic management systems, laboratory systems, financial systems, etc.), we:

• Automate data processing workflows (cleansing, standardization, and normalization).
• Configure scalable data warehouses.
• Set up and implement analytical tools for creating dashboards, reports, and data visualizations.
• Ensure a high level of data security and compliance with healthcare regulations such as HIPAA.
• Integrate machine learning and AI into analytics.

We also help build specialized analytical applications as standalone systems or embedded into Health Information Management Software with the following functionality, without being limited to it: 

• Aggregating medical, financial, operational, and claims data into one platform
• Filtering for timeframe and dimensions of DNFC, such as Current DNFB balances, DNFB by Aging, Balance, Medical Service, Location, Physician, and Payer
• Categorizing patients according to their international classification of diseases (ICD) and diagnosis codes (DX)
• Visualizing graphs with contribution margins and cost variations by ICD DX

If you're looking for expertise in data analytics, data integration, data infrastructure, data platforms, HL7 interfaces, workflow engineering, and development within cloud (AWS, Azure, Google Cloud), hybrid, or on-premises environments, we are ready to serve your needs. Contact us today to discuss your project requirements.