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Understand postservice float, DNFB, to increase productivity

HIM Connection, May 3, 2005

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Your processes for filing claims can have a big impact on the efficiency of the HIM and patient financial services department. First, consider your postservice float time.

Postservice float is the period between a service provided and an organization's claim for service transmission to its payer. The HIM department can help keep postservice float to a minimum because a claim cannot go to the payer without diagnostic and procedural codes.

Some facilities establish a bill-hold period of one to five days. The period often depends on the ability of patient-service departments (e.g., laboratory, radiology, operating room, etc.) to post their service charges to the claim file. Failure to do so in a timely fashion will result in the facility filing amended claims-a practice frowned on by third party payers. This extra filing effort adds to the workload of patient financial services. The payer may also ask for copies of the patient record, adding to the HIM workload. The efficiency, or lack thereof, of the service departments contributes to the postservice-float period and causes unnecessary work for others.

The HIM department must have the record coded within the bill-hold period. Doing so means the claim will process through the edit cycle as soon as the hold expires. The edit cycle is a cleansing process that the claim goes through to identify data discrepancies before it goes to the payer or clearinghouse. A report available the next day shows errors found for the patient financial services staff to work through and resolve. Timely processing of this report keeps postservice float to a minimum.

Another document, the "discharged-not final billed" (DNFB) balance, captures the account balances of records that remain uncoded after the bill-hold period expires. The DNFB balance does not solely represent uncoded accounts. It could also include claims that have not passed the edits and have not yet been corrected. Organizations often set goals for DNFB. They can tie goals directly to their cash-flow needs, or attempt to achieve the productivity level of their peers.

This excerpt is adapted from More with Less: Best Practices for HIM Directors.

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