Bill, We (like so many it seems) had just the same problems at Arkansas Children's Hospital. We have now developed, implemented and are live with a web based system that has so far achieved 100% accuracy with clinical trial billing. It took us a while to get there, but we did it by developing a web based system where study coordinators enroll and schedule visits (and the procedures to be performed) and then follow up after the visit to 'finalize' the procedures performed. Once this happens we have a 'back end' process that checks what was entered into our main billing/HIS system against what was finalized in the web system, any differences being reported out and fixed on the billing system. As I said, we have run many different types of clinical trials (inpatient, outpatient, observation etc..) and have so far eradicated any initial billing errors. However, we didn't get to this point overnight. While the new system was critical so that we had an independently, PI/Coordinator record of what should be billed, we also had to evaluate and re-engineer our existing people systems so that all could work together. That involved many different (and generally small) changes in process in departments like Cost Accounting, IT, Billing, Admissions, Accounting, ORA etc. but was achievable once we got everyone talking. Now we are able to offer a few additional services with the system such as tracking reports on the trial (# of patients enrolled, protocol due date reminders etc.) and web creation and routing of study reimbursement. All of which provide the PI and staff extra incentive to use the system. Obviously there is a lot more detail here as to how it all works, but wanted to let you know the basics let you all know that this problem can be fixed. -David David A Higginson, ACMA Vice President for Information Systems Arkansas Children's Hospital 1120 Marshall Street Little Rock, AR 72202 (501) 320-3757 xxxxxx@archildrens.org > Learn more about us at: <http://www.archildrens.org/> -----Original Message----- From: Caskey, William PhD. [mailto:xxxxxx@CMH.EDU] Sent: Thursday, April 26, 2001 5:18 PM To: xxxxxx@HRINET.ORG Subject: Re: [RESADM-L] Who pays for Clinical Trials This is a tough issue. If anyone has a solution, I'd like to know as well. We currently put a "hold" on all charges when a patient is enrolled in a study. All charges effectively accrue to a dummy account which is reviewed by the research nurse or project personnel monthly. All standard of care charges are backed out to the client account and the research charges are transferred to the appropriate cost center. We do have a standard of care charge code and a research charge code for each charge which does help. This is a very labor intensive process and is prone to a certain amount of error. We have some checks in place and our process has improved greatly over the last couple of years. We're always looking for a better way. Another solution is to require that all charges on a research study be paid by the sponsor, but as you know, sponsors don't get overly excited when this approach is used...Bill Bill Caskey, PhD Director, Research & Grants Administration Children's Mercy Hospital 2401 Gillham Road Kansas City, MO 64108 Voice:(816) 234-3879 FAX:(816) 855-1982 E-mail: xxxxxx@cmh.edu <mailto:xxxxxx@cmh.edu> This communication is intended only for the use of the addressee. It may contain information which is privileged or confidential under applicable law. If you are not the intended recipient or the agent of the recipient, you are hereby notified that any dissemination, copy or disclosure of this communication is strictly prohibited. If you have received this communication in error, please immediately notify The Children's Mercy Hospital at 816-234-3879 or via return Internet electronic mail at xxxxxx@cmh.edu <mailto:xxxxxx@cmh.edu> and expunge this communication without making any copies. Thank you for your cooperation. -----Original Message----- From: Barbara L. Pifel [mailto:xxxxxx@MED.CORNELL.EDU] Sent: Thursday, April 26, 2001 4:44 PM To: xxxxxx@HRINET.ORG Subject: [RESADM-L] Who pays for Clinical Trials Would anyone care to discuss possible methods to avoid duplicate billing for items or services provided as "routine care" to patents who are admitted to a hospital and who are also a participant of a clinical trial. If anyone would like to discuss this issue in confidence, please feel free to contact me directly. Barbara Barbara Pifel Senior Director Grants and Contracts Rm: A131 Telephone: (212) 746-6020 6-6058 Fax: (212) 746-6938 ====================================================================== Instructions on how to use the RESADM-L Mailing List, including subscription information and a web-searchable archive, are available via our web site at http://www.hrinet.org (click on "Listserv Lists") ====================================================================== ====================================================================== Instructions on how to use the RESADM-L Mailing List, including subscription information and a web-searchable archive, are available via our web site at http://www.hrinet.org (click on "Listserv Lists") ====================================================================== ====================================================================== Instructions on how to use the RESADM-L Mailing List, including subscription information and a web-searchable archive, are available via our web site at http://www.hrinet.org (click on "Listserv Lists") ======================================================================
