Awareness : OBC Tips

Clinical Research Billing Compliance Risks

Clinical Research Billing Compliance Risks Include…

Billing for services that are:

  1. Not covered under the Medicare Clinical Trial Policy and/or other Medicare rules. Not a Medicare Covered Service
  2. Experimental procedures not covered by commercial payers
  3. Paid by Sponsor (Double billing)
  4. Promised free in the Informed Consent
  5. Not accurately reported as required on the billing claim (special billing rules, device, procedure codes, units, etc.)
  6. Not supported by required documentation (documentation of medical necessity and study participation)