Clinical Trial Billing - Building a Compliant Process that Works!

Why Should You Attend:

Beginning in 2000, with the National Coverage Decision (now “Clinical Trials Policy” or CTP), Medicare covers routine costs for Medicare participants in clinical trials. Though designed to protect taxpayer’s funds from fraud and abuse, the rules and regulations related to the CTP can become a minefield to institutions that conduct clinical trials. Many high profile academic and community health care systems have paid a high price in fines and penalties for inadequate processes to identify, capture and appropriately bills for clinical trial items and services.

This 90-minute session will provide a thorough overview of the CTP, its associated rules and regulations and practical help in designing a process to manage clinical trial billing that will assure optimal compliance.

Learning Objectives:

At the end of this session, attendees will be able to:

• Recite the relevant terms of the CTP.
• List the essential elements of a qualifying clinical trial.
• Create a Medicare Coverage Analysis from scratch.
• Devise a system to manage the billing of clinical trial charges in compliance with Federal rules and regulations.
• Create a plan to measure and assure compliance of the clinical trial billing process.

Areas Covered in the Seminar:

• The Clinical Trial Policy and clinical trial billing.
• “Qualifying” clinical trials;  what does that mean?
• What a robust Medicare Coverage Analysis (MCA) looks like.
• Contract terms to be wary of.
• Managing the clinical trial charge from its inception to its final payment without risk.
• Monitoring the process.