DNFB

Discharged Not Final Billed (DNFB) is a metric used in hospital revenue cycle management to quantify the backlog of patient accounts that have been discharged but for which the final bill has not yet been produced. It is commonly measured in dollars (DNFB dollars) or in days (DNFB days), reflecting either the monetary value of unbilled charges or the aging of discharged-not-final-billed accounts.

Calculation and interpretation: DNFB tracks the status of discharged patients whose final billing is incomplete. The metric is often reported as the total value of discharged patients with unobtained final bills at a given time, or as the average age of these accounts. Lower DNFB indicates a more timely billing process and shorter cash conversion cycle, while higher DNFB suggests potential revenue delays and greater working capital burden.

Significance: DNFB is used to assess revenue cycle performance, identify process bottlenecks, and monitor operational efficiency. It complements other indicators such as days in accounts receivable and payer denial rates. Hospitals typically aim to keep DNFB within targets that align with their cash flow goals and payer requirements.

Common causes: Delays in discharge documentation, missing or incomplete charges, late coding, gaps in charge capture, incomplete or delayed insurance verification, and dependencies on multiple departments for data. System downtime and staffing shortages can also contribute to DNFB growth.

Management and improvement: Practices include daily DNFB reviews, clearly assigned ownership, standardized discharge-to-billing workflows, early charge capture, real-time coding, and continuous training. Automation, electronic health record optimization, and robust denial management can also help reduce DNFB and speed revenue realization.