Hand-in-Hand:Research and Billing

Wendi R. Mason, NPInterstitial Lung Disease Clinical Coordinator

Overview

Building a BudgetCommunication

With the sponsor With the Department of Finance With your Division and Grants & Contracts

Day to DayReconciliationAnnual invoices

Building a Budget

Money Money Money Money Money Money

Your Budget Create your own system Use the Department of Finance Website

CPT Code and Price List

Example:

CPT Code CDM Descriptor Cost D&H_______

94720 28010031 Diffusing capacity $317.00 $136.0094240 28010056 TLC $389.00 $124.4894060 28010098 pre-post bronchodilator $622.00 $199.04

On and on and on…

Last updated: 2/02/2007

Creating your own Budget

Standard of Care Study D&H CostProcedure # each total # each total # each total_

Screen Physical (1) $ 450 $ 450 (1) $450 $ 450PE (9) $ 150 $1350 (9) $150 $1350Facility Fees (9) $ 204 $1836 (9) $200 $1800 (9) $ 44 $

403HRCT (1) $1749 $1749 (1) $1550 $1550 (1) $384 $ 384PFTs (9) $ 727 $6543 (9) $ 350 $3150 (9) $159 $1439etc.etc.Formulas for percent effort (Kathy to discuss)Don’t forget overhead!

Totals: $ 16244 $ 12000 $ 4900

Communication

With the Sponsor…

As you are all aware, many times the budget that the sponsor provides is rather weak.

Negotiate with them! They have money! They usually have a “top” amount that they are not supposed to go over, and the amount that they provide at the beginning, is not it.

Not every study may be fruitful… but you need to be sure that you are not putting your center in the red.

Communication

With the Department of Finance

Website: http://finweb.mc.vanderbilt.edu/index.aspTechnical Charges

Alison Culley, Dianne R. McGrath Office 322-0200, Fax 936-6851

D&H Charges (Technical) Nancy B. Stanley

Professional Charges (VMG) Judy Cooper, Cindy Charvis, Lee Ann Buck

Communication

With the Department of Finance

Required Forms: Project Information Page Clinical Research Budget Grid Clinical Trials Registration Form Transmittal Form

(All forms are located on their website)

Communication

With the Department of Finance

“Please be patient.”“Be timely.”“Review billings carefully.”“Look for trends in errors.”“We are here for you.”

Communication

With your Division/Department and

With Grants and Contracts

Complete your required paperwork for the Department of Finance and submit this with your Contract to your contact person within your Division/Department.

Communicate with these people regularly to ensure that your project is not getting buried.

Grants and Contracts Janet Fry

Communication

Know the Language

BUILD 3060963692-8000404-383-7485AC-052-321 ACTELION LANCASTER070049

Day to Day

Prevent billing errors before they happen. In scheduling patients, ensure that they are

scheduled to be billed to the appropriate account.

Ensure use of the Clinical Trial ICD9s: V70 – standard of care V60 – D&H

Review every billing sheet you are able to see: Lab orders Radiology Encounter forms

Reconciliation

More than one way… Financial Statements E-Dog (Kathy Price)

Monthly I receive: Financial StatementsTechnical ChargesProfessional Charges

Reconciliation

Carefully review the Monthly billing sheet from the Technical side and the Claim Form from the Professional side.

Correct patient?Correct procedure?Correct D&H?

What to do with Errors

Patient states that their bill is wrong Have them send you the bill, verify error, then contact

appropriate entity. Professional fees:

Contact Lee Ann Buck, 6-0515 Provide medical record, date of service, and the charge

and why it is incorrect. Technical charges:

Fax the monthly statement to Alison/Dianne at 6-6851 circle the error and briefly explain the problem.

Invoices

Consider doing this annually with your continuing review.

Ensure your invoice includes the correct center number and remittance address.

This can be quite a bit of money! IRB fees Pharmacy fees Screen Failures Patient payments Anything that you previously discussed in your contract