[MT-L] Calculating DNFB
Cole, Beth
Final Billed (DNFB) for the hospital. We're interested in hearing how
others calculate the number.
Our method for month-end:
From ESS, we take the B/AR Receivables number from the B/AR Period End
view. This is a hard-close number based on the day close & month close
in B/AR.
From this, we subtract the total amount on an ABS HIM Unbilled Accounts
compiled report. This gives us the accounts that are discharged in ADM
but that do not have final abstracts. This is not a hard close number.
That gives us the total receivables that have been finalized but not
been billed.
We're open to changing how we calculate this, if there are other, better
places to get the information. So, how do you accomplish it?
Also, if someone has a report to show a list of accounts in B/AR that
have a final diagnosis but that have not been billed, I'd love to have
it. Our Patient Accounts Supervisor is constantly frustrated by not
having that information.
Beth Cole
Senior Systems Analyst
Newman Regional Health
Emporia, KS 66801
v: 620.343.6800 x1131
f: 620.340.6797
www.newmanrh.org <http://www.newmanrh.org/>
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Kim Scaccia
Do you use Proration holds in your organization? Do you have an ancillary
claim scrubber? Do you rely on outside companies for any charges or
coding?
For true DNFB you have to determine where your claim scrubbing is
happening. For example, some organizations have ancillary billing
applications that 'scrub' a claim for errors prior to billing. This can
be a black hole that a claim can sit in for quite some time if you don't
have good policies and procedures to track them. If this is occurring,
then you may want determine if your ancillary application can provide you
a figure of claims in error or claims on hold on a particular date to
count them as DNFB.
For those who do this very well, proration holds are utilized and assigned
to groups for responsibility. For example primary diagnosis, final
abstracting - those are assigned to coding; Missing policy numbers or
missing subscriber relationship would be assigned to admissions; Missing
ER Level charges to the ED area and so forth. If you do this, you can
actually use the unprinted bills detail (excluding the INSBAL Hold) to get
a more accurate count of discharge not final billed.
Let me know if I can be of further assistance.
Kimberly Scaccia | Senior Management Consultant | Jacobus Consulting,
Inc.
C. 386.871.5605 | F. 949.713.6742 | ksca...@jacobusconsulting.com |
www.jacobusconsulting.com
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Rahn, Joni
1) BAR Unprinted Bills - this will include any accounts holding due to proration holds, i.e, diagnosis, final abstract, authorization #, etc.
2) BAR Claim Check Rejection List
3) Claims Mgmt System Holds (we use ePremis and are able to print a list of claims holds)
Joni Rahn
Director, Patient Financial Services
Halifax Health
Daytona Beach, FL
(386) 239-2452
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-----Original Message-----
From: meditech-...@mtusers.com [mailto:meditech-...@mtusers.com] On Behalf Of Cole, Beth
Sent: Thursday, August 18, 2011 9:34 AM
To: medit...@MTUsers.com
Subject: [MT-L] Calculating DNFB
Amber Adkins
For the last piece, we schedule a selection report to run every night
with the following criteria. This will list everything that ABS has
final'd but is still in a UB/PRELIM status. I think that is what you
are looking for.
Inc
Exc
Uses Nil
Select Field Index Any Use Query From Value Thru Value
CUR STATUS Y I UB UB
ADM/SER DATE Y I T-365 T-5
BILL STATUS N I PRELIMINARY PRELIMINARY
ABS STATUS N I FINAL FINAL
CUR BALANCE N E 0 0