Health information management (HIM) software with integrated analytics modules is utilized by healthcare organizations with tens of beds and a large number of physicians. They tell about an enhancement in Discharged Not Final Billed (DNFB) rates, indicating more effective payment recovery after patient release. In certain situations, this enhancement leads to an extra 1 million dollars in yearly reimbursement for the care provided to patients. What actions do healthcare organizations need to take to attain such remarkable outcomes?
If healthcare organizations use analytics software to detect and resolve incomplete invoices, they will enhance DNFB rates and decrease pending patient payments. This approach safeguards them from failing to meet national average standards in specific metrics, such as the surgical capture rate for patients with coexisting conditions.
However, the lack of appropriate analytical tools results in challenges in meeting DNFB enhancement objectives and hitting the desired benchmarks.
Challenges on the Way to Enhanced DNFB
Healthcare systems consistently face a shortage of effective strategies to enhance their financial outcomes, control expenses, and boost revenue. In their attempts to reach those goals, hospital CEOs may opt for layoffs or reducing operational expenses. These actions may create a sense of effectiveness.
However, they will ultimately impact staff motivation and morale while adversely affecting the patients’ care. This is why it is profitable for healthcare providers to adopt analytical tools capable of handling the following tasks:
- Enhancing documentation precision, resulting in advancements in the case mix index (CMI). This metric enables providers to evaluate the expensiveness of each specific case based on the symptom severity, diagnosis, and necessary resources. Therefore hospitals will expect appropriate levels of reimbursement
- Detecting and addressing DNFB cases where the causes of incomplete bills are related to coding inaccuracies or insufficient and inaccurate documentation
- Analyzing opportunities that provide the greatest impact on achieving financial KPIs and further focusing efforts on those prioritized areas
- Reducing the number of unfinalized bills and thereby shortening accounts receivable (A/R) days
- Establishing priorities using analytics software and meeting benchmarks in key areas, such as minimizing documentation gaps
- Guaranteeing that the time and resources invested in enhancements produce benefits and maintaining the outcomes achieved
- Reporting results and ensuring visibility to continuously monitor performance with the aim of preventing the loss of achieved outcomes.
Features of HIM Software to Generate More DNFB Revenue
To accomplish the goal of improving DNFB rates and addressing the aforementioned challenges, healthcare systems depend on analytics software. With its assistance, organizations accomplish the following:
- Obtain the necessary data quickly and effortlessly, and pinpoint the specific areas where issues arise
- Utilize patient clinical, insurance claims, operation, and financial data on a single platform
- Enhance physician documentation and decrease the number of A/R days and pending bills
- Examine the documentation and implement precise coding
- Analyze surgery patients' data to determine if they have comorbid conditions and verify if their accounts were correctly coded
- Oversee the accounts of released patients with unfinished billing and identify the cause of the delays
- Track and maintain the positive trends in DNFB rates, A/R days, and work processes for coders and doctors
- Remove manual tasks and integrate DNFB data into in-hospital environments like workflows and dashboards.
Organizational Measures to Enforce DNFB Analytics
Healthcare systems must take certain organizational steps before and during new software application. It will assist in making the process seamless and smooth.
- Hospital executives should allocate investments meaningfully in analytics and resources needed to enhance DNFB rates
- It is advised that hospital CEOs collaborate with physicians to ensure medical documentation is accurately recorded and represents the health condition of each patient
- It is suggested that financial directors grant their office managers access to the system. They could detect incomplete documentation and urgently address those cases with doctors. Without this functionality, coders need several days to inform doctors about these issues.
What Benefits Can Be Gained from Using DNFB Analytics?
Health information management software offers healthcare systems consolidated data that they use to examine the causes of elevated DNFB rates and take action to enhance the situation.
- Using the analytical tool, as indicated, yields the following improved outcomes for providers:
- Additional yearly reimbursement for the correct level of care provided, thanks to more accurate clinical documentation and enhanced CMI
- Substantial reduction in the number of pending accounts
- A significant decrease in DNFB dollars, which positively impacts cash flow
- Meaningful decrease in the share of physician DNFB dollars
- Seizing the opportunity not only to enhance performance but also to maintain the outcomes, such as reducing A/R days.
How a Healthcare Software Development Company Can Assist
An outsourcing company like Belitsoft that specializes in healthcare software development assists top healthcare data analytics companies in building robust data operating systems.
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.), the healthcare software development companies:
- 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.
They also assist in developing specialized analytical apps such as Health Information Management Software for:
- Consolidating medical, operational, financial, and claims data into a single platform
- Filtering by timeframe and DNFB dimensions, for instance, DNFB by payer, physician, location, medical service, balance, aging, and current DNFB balances
- Classifying patients based on international classification of diseases (ICD) and diagnostic codes (DX)
- Visualizing graphs with contribution margins and cost variations by ICD DX.
If you are looking for expertise in data analytics, data infrastructure, data platforms, HL7 interfaces, workflow engineering, and development within cloud (AWS, Azure, Google Cloud), hybrid, or on-premises environments, a healthcare software development company like Belitsoft also can serve these needs.
