DNFB stands for discharged not final billed. It’s the set of patient accounts where the patient has been discharged and care is complete, but a final claim hasn’t been produced yet. Money in DNFB has been earned but can’t be collected, because nothing has gone to the payer. It’s a hospital and facility metric first, but the same idea applies to any practice with completed visits waiting on coding or charge entry.
How Is DNFB Measured?
HFMA’s MAP Keys define the standard measure as Days in Total Discharged Not Final Billed (MAP Key PB-1). The formula is:
- Numerator: gross dollars in discharged-not-final-billed accounts, taken from unbilled A/R
- Denominator: average daily gross patient service revenue
So a facility with $9 million sitting in DNFB and $900,000 in average daily gross revenue has 10 DNFB days. HFMA calls it a trending indicator of the claims generation process. Tracking it in days instead of dollars keeps the number comparable when patient volume changes.
HFMA has a related measure for what happens next: Days in Final Billed Not Submitted to Payer (FBNS, MAP Key PB-2). That counts claims that are final billed but held up by edits in the claims processing tool. DNFB is the backlog before the bill exists. FBNS is the backlog after the bill exists but before it leaves.
What Causes DNFB to Build Up?
- Coding backlog. Coders can’t keep up with discharge volume, often because of staffing gaps.
- Unanswered physician queries. A coder needs clarification on documentation, and the account sits until the physician responds.
- Missing documentation. Discharge summaries, operative reports, or pathology results aren’t in the record yet.
- Charge capture gaps. Charges from a department haven’t posted, so the account can’t be finalized.
- Holds for review. Clinical documentation integrity (CDI) review or compliance holds that have no turnaround standard.
Why DNFB Matters Beyond the Number
Every day an account sits in DNFB adds to days in A/R and delays cash. It also eats into timely filing windows. A claim that sits unbilled for weeks has less time left if it gets rejected or denied later.
How to Reduce DNFB
- Measure it daily, not monthly. DNFB is a flow problem, and a monthly snapshot hides where accounts get stuck.
- Break it down by hold reason: coding, query, documentation, charges, or review. Each reason has a different owner.
- Set turnaround standards for physician queries and escalate when they’re missed.
- Staff coding to discharge volume, including backup or outsourced coding capacity for peaks.
- Reconcile charges daily by department so missing charges are found before the account ages.
Frequently Asked Questions About DNFB
What does DNFB stand for in medical billing?
Discharged not final billed. It refers to accounts where the patient has been discharged and care is complete, but a final claim has not yet been produced.
How do you calculate DNFB days?
HFMA’s MAP Key PB-1 divides gross dollars in discharged-not-final-billed accounts by average daily gross patient service revenue.
What is the difference between DNFB and FBNS?
DNFB is accounts not yet final billed. FBNS, final billed not submitted, is claims that have been final billed but are held by edits before being sent to the payer.
What is the most common cause of high DNFB?
Coding backlogs and unanswered physician queries are among the most common causes, along with missing documentation and charge capture gaps.
What OmniBridge Actually Does
We give facilities and larger groups coding capacity that scales with volume, and we report unbilled accounts by hold reason so the right team works each one.
If your unbilled backlog keeps growing, request a free practice audit and we’ll break it down by cause with you.
