Research Billing & Internal Invoicing

(For all coordinators, research nurses and Principle Investigators)

How does my grant get billed for trial related services which are not standard of care and not billable to 3rd party payers?

Anytime your study participant has visited the hospital as part of the study and they have been:

• properly registered
• received clinical services (tests/procedures/services)
• charges have been properly posted to the participant's research account for those services

The Hospital and Physican billing offices sends the CTO all resulting charges on a monthly basis for review.    

What Will Happen:

1. The CTO will confirm that the charges for each patient are study related by checking our database to determine if the patient was enrolled in a study and to determine if the date of service corresponded with their period of participation.
2. We will then evaluate the charges to determine if the services were:
   1. Related to the study protocol.
   2. Budgeted to be billed to your grant.
3. The CTO will then:
   1. Contact the study coordinator or investigator if needed to provide further instruction.
   2. Adjust the charges to apply the appropriate research discount rate if the charges are to go to your grant.
   3. Instruct the relevant billing department to bill the 3rd party payer if analysis indicates this is appropriate.
   4. Create an internal EOB instructing the hospital billing department to split the charges between the grant and 3rd party payer if analysis indicates this is appropriate.
4. An invoice will be created by the CTO which will result in your RX account being debited for those services and payment made to MedStar.
5. Your next CSR (center status report) will indicate this debit with a line item describing the CTO invoice using the following example nomenclature: "CTO PFS 110101" which will indicate that the charges were CBO related (hospital charges) and the date of the invoice.