Clinical Research and Clinical Trial Professional and Technical Fee Billing: Difference between revisions

no edit summary
No edit summary
No edit summary
Line 17: Line 17:
</table>
</table>
<br />
<br />
[[Compliance Program]] | [[Compliance Hotline]] | [[Investigations by Third Parties]] | [[Research Integrity]] | [[Export Control]] | [[Code of Conduct]] | [[Use of Human Anatomical Material]] | [[Clinical Trial Professional and Technical Fee Billing]] | [[Contracts]] | [[Conflict of Interest]] | [[Red Flag Identity Theft Prevention Program]] | [[Principles of Financial Stewardship]] | [[Human Tissue Use and Transfer]] | [[International Research Policy]] | [[Health Care Vendor Interactions]] | [[Credit Hour Definition]]
[[Compliance Program]] | [[Compliance Hotline]] | [[Investigations by Third Parties]] | [[Research Integrity]] | [[Export Control]] | [[Code of Conduct]] | [[Use of Human Anatomical Material]] | [[Clinical Trial Professional and Technical Fee Billing]] | [[Contracts]] | [[Conflict of Interest]] | [[Red Flag Identity Theft Prevention Program]] | [[Principles of Financial Stewardship]] | [[Human Tissue Use and Transfer]] | [[International Research Policy]] | [[Health Care Vendor Interactions]] | [[Credit Hour Definition]] | [[Whistleblower]]
<br /><br />
<br /><br />
Policy No.: '''8008'''<br />
Policy No.: '''8008'''<br />
Line 24: Line 24:
Reviewed Date: '''07/20/18''' <br />  
Reviewed Date: '''07/20/18''' <br />  
<br />
<br />
<big>'''Clinical Trial Professional and Technical Fee Billing Policy</big>'''
<big>'''Clinical Research and Clinical Trial Professional and Technical Fee Billing Policy</big>'''
<br /><br />
<br /><br />
== Policy ==  
== Policy ==  
Line 69: Line 69:
*Items or services needed for reasonable and necessary care arising from the provision of an investigational item or service – in particular, for the diagnosis or treatment of complications.
*Items or services needed for reasonable and necessary care arising from the provision of an investigational item or service – in particular, for the diagnosis or treatment of complications.
===Research Costs===
===Research Costs===
Patient care costs that are associated with the research trial or clinical research should be paid by the research grant or contract. These costs are not billable to Medicare and/or a third party payer.   <br />
Patient care costs that are associated with the research trial or clinical research should be paid by the research grant or contract. These costs are not billable to Medicare and/or a third party payer.<br />


Examples of items and services that are specifically included as research costs are:  
Examples of items and services that are specifically included as research costs are:  
Line 81: Line 81:
*[https://www.unmc.edu/academicaffairs/_documents/compliance/MedicareQualifyingClinicalTrialsFlowsheet1.pdf Medicare Qualifying Clinical Trials Flowchart]  
*[https://www.unmc.edu/academicaffairs/_documents/compliance/MedicareQualifyingClinicalTrialsFlowsheet1.pdf Medicare Qualifying Clinical Trials Flowchart]  
*[https://www.unmc.edu/academicaffairs/_documents/compliance/ABNRequirementsFlowchart.pdf Advanced Beneficiary Notice Requirements Flowchart]  
*[https://www.unmc.edu/academicaffairs/_documents/compliance/ABNRequirementsFlowchart.pdf Advanced Beneficiary Notice Requirements Flowchart]  
*Nebraska Medicine [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=now One Chart Training Classes] Policy (IM10)
*Nebraska Medicine Policy IM10, [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=now One Chart Training Classes]  
*Nebraska Medicine [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=nowOne Chart Research Documentation] Policy (IM41)
*Nebraska Medicine IM41, [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=nowOne Chart Research Documentation]  
*Nebraska Medicine [https://www.unmc.edu/academicaffairs/_documents/compliance/NE_Medicine_2015-Tip-Sheet-Looking-Up-Grant-Charges-on-Statements.pdf One Chart Tips and Tricks Sheet] - Looking Up Grant Charges on Statements
*Nebraska Medicine [https://www.unmc.edu/academicaffairs/_documents/compliance/NE_Medicine_2015-Tip-Sheet-Looking-Up-Grant-Charges-on-Statements.pdf One Chart Tips and Tricks Sheet] - Looking Up Grant Charges on Statements
*Nebraska Medicine [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=now Advanced Beneficiary Notice (ABN)]Policy (MI15)
*Nebraska Medicine Policy MI15, [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=now Advanced Beneficiary Notice (ABN)]
*Nebraska Medicine [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=now Research Billing Process] Policy (MI19)
*Nebraska Medicine Policy MI19, [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=now Research Billing Process]  
*Nebraska Medicine [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=now Investigational Devices] Policy (MI29)
*Nebraska Medicine Policy MI29, [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=now Investigational Devices]  
*Nebraska Medicine [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=now Admission/Registration to Nebraska Medicine] Policy (RI06)
*Nebraska Medicine Policy RI06, [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=now 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 SOP 201.2 Insurance Predetermination] Form
*Nebraska Medicine [http://now.nebraskamed.com/?utm_source=default&utm_medium=ie&utm_campaign=now SOP 201.2 Insurance Predetermination] Form