Conducting Clinical Trials Billing Risk & Coverage Analysis

Event Information
Product Format
Prerecorded Event
60 minutes
Product Description

Tips to Ensure Items and Services Provided in a Clinical Trial are Billed and Reimbursed Properly

Clinical trials involve routine and non-routine items and services. Since these are all part of a clinical trial, standard treatment protocols are changed and one needs to determine how the costs for care will be reimbursed. There may be multiple payors, including the sponsor and the patient’s insurer. Becoming familiar with what is a billing risk and how to conduct a coverage analysis will ensure that the items and services provided as part of a clinical trial are billed and reimbursed properly.

Join expert speaker Gail Madison-Brown in this informative session to learn how to conduct a billing risk on a clinical trial study and get a sample tool to conduct a billing risk. You will also learn how to conduct a Medicare coverage analysis and also develop an associated billing spreadsheet.

Session Highlights:

  • Clinical trials routine and non-routine items and services
  • What is a clinical trial and coverage analysis
  • Determining billing risk of a clinical trial
  • Conducting a billing risk
  • Conducting a Medicare coverage analysis
  • Developing a billing spreadsheet to ensure proper billing of identified services
  • Get a detailed look at the Clinical Trial Billing cycle
  • Find examples of potential billing errors
  • Medicare’s Reasonable and Necessary rule
  • Specific CMS Research Billing rules
  • Steps for Qualifying a Trial for Coverage and Coverage Analysis
  • Modifier Q0 and Q1
  • And more!

Who should attend

Clinical trial research team members, coders and billers involved with coding/billing clinical trials. Principal Investigators, individuals responsible for ensuring proper billing assignment for clinical trials, including Clinical Trials office personnel

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

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About Our Speaker

Gail Ann Madison Brown


Gail Madison-Brown has extensive experience in healthcare compliance, revenue cycle, auditing and coding programs. She has over 25 years of experience as a Registered Nurse and many years as an attorney. She has spoken for professional healthcare organizations, as well as for state public health departments.

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