MCA Medicare Coverage Analysis
CMS Reimbursement Approval
Billing Audit / CBO
Letter of Indemnification
Facility Use Agreement / Hospital Use Agreement (FUA/HUA)
Your CTA and budget are negotiated, the study is IRB approved, you start to screen patients...then the office manager asks you how to bill the office visit.
Beyond the schedule of events in the protocol, there are additional items that will appear on the patient's bill. The billing grid will go beyond the tests and services listed in the schedule of events to create a detailed table of all of the billable items associated with each visit. Da Vinci Research Solutions works closely with Investigators and Study Coordinators while preparing billing grids to ensure that the final document produces billing compliance for your facility.
When the billing grid is complete, your institution will receive a study-specific table that lists all items and services to be provided, as part of the clinical trial, with documentation of what should be billed to the research sponsor (or study) and what can be billed to Medicare (or Insurance). These billing grids are a necessary tool to avoid double-billing.
In addition to the billing grid, you will receive a study-specific Research Encounter Form that can be used to alert Registration, Coding, Nurse Auditors, and Billing Departments to coding requirements and items to be billed to the study.