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 been properly registered, had their encounter forms/fee slips properly filled out, and received clinical services (tests/procedures/services), the CTO will receive all resulting UB92’s (hospital bill) and 1500’s (professional fees bill).
What Will Happen
- The CTO will determine if the bill is grant related by checking our database to determine if the patient was enrolled in a study.
- We will then evaluate the charges to determine if the services were:
- Related to the study protocol.
- Budgeted to be billed to your grant.
The CTO will
- Contact the study coordinator or investigator if needed to provide further instruction.
- Adjust the charges to apply the appropriate research discount rate if the charges are to go to your grant.
- Instruct the billing department to bill the 3rd party payer if analysis indicates this is appropriate.
- 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.
An invoice will be created by the CTO which will result in your RX being debited for those services and payment made to MedStar.
Your next CSR (center status report) will indicate this debit with a line item describing the CTO invoice.