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Clinical Research and Clinical Trial Professional and Technical Fee Billing: Difference between revisions
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Clinical Research and Clinical Trial Professional and Technical Fee Billing (view source)
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==Qualified Clinical Trials== | ==Qualified Clinical Trials== | ||
Only qualified clinical trials or clinical research are eligible for reimbursement for routine costs under Medicare. In order to be a qualified trial, three mandatory criteria must be met as well as have other desirable characteristics per the [https://www.unmc.edu/academicaffairs/_documents/compliance/MedicareQualifyingClinicalTrialsFlowsheet1.pdf Medicare Qualifying Clinical Trials Flowchart]. | Only qualified clinical trials or clinical research are eligible for reimbursement for routine costs under Medicare. In order to be a qualified trial, three mandatory criteria must be met as well as have other desirable characteristics per the [https://www.unmc.edu/academicaffairs/_documents/compliance/MedicareQualifyingClinicalTrialsFlowsheet1.pdf Medicare Qualifying Clinical Trials Flowchart]. | ||
===Three mandatory criteria=== | ===Three mandatory criteria=== | ||
*Trial evaluates an item or service that falls within a Medicare benefit category (e.g. physicians' service, durable medical equipment, diagnostic test) that is not statutorily excluded from coverage (e.g. cosmetic surgery, hearing aids); | *Trial evaluates an item or service that falls within a Medicare benefit category (e.g. physicians' service, durable medical equipment, diagnostic test) that is not statutorily excluded from coverage (e.g. cosmetic surgery, hearing aids); | ||
*Trial has therapeutic intent. | *Trial has therapeutic intent. | ||
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*Nebraska Medicine Policy RI06, [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign= Admission/Registration to Nebraska Medicine] | *Nebraska Medicine Policy RI06, [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign= Admission/Registration to Nebraska Medicine] | ||
*[https://www.unmc.edu/academicaffairs/_documents/compliance/Clinical_Trial_Insurance_Predetermination_Request_Form.pdf Clinical Trial Insurance Predetermination Request] Form | *[https://www.unmc.edu/academicaffairs/_documents/compliance/Clinical_Trial_Insurance_Predetermination_Request_Form.pdf Clinical Trial Insurance Predetermination Request] Form | ||
*Nebraska Medicine [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign= now Nebraska Medicine SOP 201.2 Insurance Predetermination] Form | *Nebraska Medicine [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=now Nebraska Medicine SOP 201.2 Insurance Predetermination] Form | ||
*Nebraska Medicine [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign= now Nebraska Medicine ACCESS-REGSP-110] | *Nebraska Medicine [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=now Nebraska Medicine ACCESS-REGSP-110] | ||
* [https://grants.nih.gov/policy/clinical-trials/definition.htm National Institutes of Health] | * [https://grants.nih.gov/policy/clinical-trials/definition.htm National Institutes of Health] | ||
This page maintained by [mailto:dpanowic@unmc.edu dkp]. | This page maintained by [mailto:dpanowic@unmc.edu dkp]. | ||