Calendar Review & Analysis Office · 2018-04-10 · Calendar Review & Analysis Office...

Calendar Review & Analysis Office

Clinical Research Billing Town Hall June 21, 2013 Gina Vuocolo-Branch Director Calendar Review & Analysis Office (CRAO)

§ New Michigan Budget Enrollment Calendar Tool (MBECT) platform

§ Screen shots § What’s new? § MBECT Training § Clinical Research Billing Process § What you should know § Q&A

Today’s Agenda

MBECT Overview

§  MBECT is a tool designed for and by study teams § Create IRB application materials:

§ Billing calendar § Budgets

§  Enroll study subjects and track their progress §  Invoice based on milestones or events §  Track payments from sponsors § Report functionality

What hasn’t changed

§  MBECT created billing calendar is needed if: §  Your study has billable items/services §  Active study §  Accruing subjects §  Billing issue has been reported

§  MBECT enrollment must be done the same day the patient signs the consent (ICF) §  If possible prior to the service completion

New Platform for MBECT § Does NOT significantly impact your current

workflow § More reliable

§ Saves when you hit save § Fewer bugs, glitches, and work-arounds

§ Offers additional functionality §  Incorporated user feedback into existing capabilities

New Platform for MBECT §  Bigger screen size

§  Expand the window to full screen like any other website §  Still not big enough? Expand individual sections further

using the “+” button

New Platform for MBECT §  Ability to rename charge master items

New Platform for MBECT §  More flexibility searching for items and adding

activity to the BC § New multi-select functionality

New Platform for MBECT §  Shortcut to search for HC/PC components

Note: Some HC charges do not have a CPT or a PC

Click on item/group you want to find other components and right click to get the drop down menu

Adding a comment

New Platform for MBECT §  Ability to display multiple calculations

§  See sponsor/research margin at a glance

New Platform for MBECT §  Ability to create MCRU schedule of events

MBECT Training §  MLearning §  Hands on training classes §  Friday Workshops 9-11 am and 1-4 pm

§ Hands-on help at NCRC §  Bring your questions for our Subject Matter

Experts (SME’s) § Not a substitute for a training class

§  Help Desk 764-5669 §  CRAO-MBECT-help@med.umich.edu

New Options

§  New Financial Options Available – Track individual subject progress through a trial

§  Includes a short cut to mark subjects that screen fail § Assists with reconciling your study accounts

§ Create milestones for tracking and invoicing § Create and reconcile invoices, payments, and

advances § Multiple ways to calculate salary considerations

Future interfaces with MiChart

§  Interfaces will reduce clinical research billing issues § Batched enrollment interface with MiChart

slated for September 2013 §  Live real time enrollment interface with

MiChart slated for June 2014 § Batched research record (procedures and

demographics) creation interface with MiChart slated early 2015

Clinical  Research  Billing  

Patient Visit

Charges entered

Is patient enrolled in study?

Charge routed to patient account

Is charge on BC?

No No

Yes Yes

Systematic Decisions

Charge routed to patient account

Clinical Research Billing - Current Workflow

Research Workflows (Billing)- Current State

Charges route RCRB

WQ

Review charge

against BC

Is charge paid by study?

Charge routed to

study acct

Charge routed to patient account

Yes

No

CRB- Current Workflow cont’d

Billing Calendar

(RSH)

Patient Enrollment

(LAR)

§  BC has all expected research related charges listed and these are added to the RSH allowable services

§  Optimum for patient to be enrolled in MBECT & MiChart before charge is put into the system

Studies in MiChart have 2 parts:

Clinical Research Billing - Current Workflow

Role  of  BC  in  MiChart  Data  Crea4on  

§  BC  created  in  MBECT  will  have  expanded  content  behind  the  scenes    

§  Remove  some  of  the  guess  work  of  picking  a  code  §  No  addi?onal  work  for  study  team  members  

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Office Visit

Level 3

You  Enter:   You  Get:  Office Visit Level 1 Office Visit Level 2 Office Visit Level 3 Office Visit Level 4 Office Visit Level 5

Role  of  Enrollment  in  MiChart  Data  Crea4on  

§  Enrollment  entered  in  MBECT  by  Study  Team  §  Entered  manually  into  MiChart  same  day  by  CRAO  staff  

§  Enrollment  data  creates  Study  Subject  Record  (LAR)  in  MiChart  

§  LAR  allows  study  subject  to  be  associated  with  Research  Record  (RSH)  in  MiChart  

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How  does  MiChart  know  “I'm”  in  a  study?  

Subject signs consent

Study Team enters

enrollment & subject status

in MBECT

MBECT exports

enrollment report

Enrollment manually entered in MiChart

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TRIGGER

Fine  Tuning  Enrollment  

§ Should  I  future  date  enrollment  in  MBECT?  NO  

§  Enter  subject  demographic  informa?on    § Do  not  click  “Add  Trial”  un?l  the  pa?ent  signs  the  ICF  

§  If  a  pa?ent  is  enrolled  and  does  not  arrive  for  a  visit,  all  pa?ent  charges  will  be  stopped  unnecessarily  in  the  research  WQ.  This  in  turn  costs  UMHS  ?me  and  money  and  more  importantly  pa#ent  billing  complaints  

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Unexpected  service/visit  

§  Unplanned  occurrence  (complica?on)  §  Complete  the  unscheduled  occurrence  form  §  Email  to  CRBIssues-­‐help@med.umich.edu  

§  Submission  of  this  form  enables  RCRB  to  find  the  charges  and  route  to  the  RMRN  

§ Where  do  I  find  the  form?  §  On  CRAO  website  §  Email  CRBIssues-­‐help@med.umich.edu    

Things you should know

§  Submit all clinical research billing issues and questions to the CRAO

§ We are your advocate and your central contact

§ Complete a CRB Charge Correction Request and send to:

CRBIssues-help@med.umich.edu

Things you should know…cont’d

§  “NEW” Add PC (Professional Component) on BC for ALL diagnostic tests/procedures, EKGs, EMGs, Echos, Labs, and X-rays/Imaging, etc. §  Assign sponsor non-billable (SNB) code if one

of the following applies: §  Items/Services covered by PI effort § Read off site

§  This avoids double billing (billing insurance for payment and PI effort)

Things you should know…cont’d §  Add a comment on the BC to explain your case §  If item/service was performed at a UMHS site by:

§  non research personnel §  Sponsor is not supplying the item/service

§  SOC would be used

– Some items have no professional component •  Equipment •  Pharmacy •  Recovery Room •  Supplies (trays, catheters, guidewires, implants, etc.)

Things you should know..cont’d

§  Request RMRN (aka 7000 account) §  Form is on the CRAO website § Complete form and send to

researchsubjects@med.umich.edu §  Billing Calendar (BC) Conversion project

§  Excel BC’s were converted to MBECT format § Review the BC and make changes §  Submit Amendment in eRRM and upload the BC

§ The letters “BCP” indicates that we converted the BC

§  Charge corrections should be requested within 90 days of date of service or within 3 months of statement receipt – This is for charges that were billed to study

account and according to billing calendar should have been billed to patient/insurance

•  Allows for charges to be billed to insurance before claim filing limit is met

•  Causes lost revenue to the Institution when corrections are untimely

Things you should know, cont’d

Things you should know…cont’d

§  V70.7 can be a secondary diagnosis §  Primary diagnosis only for healthy subjects

unless signs and symptoms available to use §  Charge corrections for dates of service

prior to 2/1/12 can no longer be completed §  MAC letters for devices

§ Medicare Part A & B approval for devices is an electronic process

Things you should know, cont’d §  UMHS sends two statements §  If no payment or response, account is sent

to pre-collections – Computer Credit, Inc. (CCI) does not affect a

subject’s credit score – Subject will receive a letter once every 2

weeks §  If outstanding balance at 121 days, the account

will be placed in bad debt

HOW CAN I RECONCILE MY CHARGES?

How do I reconcile my study account?

Request  form:  Research  Statement  

§  Report  2  Web  (R2W)  Research  Statement  §  New  reports  the  2nd  of  each  month  for  ac?vity  of  previous  month  

§  Request  for  statement  form  is  on  the  CRAO  website  

§  Submit  the  completed  form  to:  CRBIssues-­‐help@med.umich.edu  

Research Study Statement

Reconcilia4on  of  Charges  

§  Study  teams  are  responsible  for  reconciling  the  charges      

§  When  charges  you  expect  to  be  on  the  Research  Statement  are  not  present  then:  §  No  charges  were  posted  to  the  RMRN  

§  Charges  may  have  posted  to  the  pa?ent’s  MRN/insurance  §  Charges  are  pending  §  Charges  are  in  a  work  queue  wai?ng  to  be  processed  §  Charges  were  not  entered  into  MiChart  or  charge  interface      

§  Check  MiChart  frequently  for  the  most  current  study  account  transac?ons  

§  Compare the statements to your enrollee list and billing calendar

§  Check MiChart for subject transactions (see screenshots and steps in the Appendix)

§  If  issues  are  discovered:  §   Complete  a  charge  correc?on  request  form    §   Send  to  the  CRAO  CRBIssues-­‐Help@med.umich.edu    

§  If  you  would  like  to  speak  to  the  CRB  Lead,  call  998-­‐6569  

Steps  to  Reconcile  Your  study  account

Submit'to:'crbissues.help@med.umich.edu Date'submitted:

Requested(by Email Phone(#/Fax(# Department Title

Study:' HUM'#'

Request'being'made?

Patient'Name MRN'Study/Protocol

VisitDate'of'Service

Item/Service(include'quantity)

ProFee'(CPT) CDM/EAP Specify'your'request'from'the'drop'down'selectionMove'to'Acct:'(include'visit'#)

version(11/14/2012

Additional'NotesCharge'Information'(*complete'information'if'known)

Clinical(Research(BillingCHARGE(CORRECTION(REQUEST(FORM

PI:'

Requestor's'Information

Patient'Information

Location

Charge  Correc4on  Request    Worksheet  

Complete form and send to CRBIssues-help@med.umich.edu

MICHART SCREEN SHOTS & STEPS Reconciliation-MiChart Screen Shots Step by Step

APPENDIX

Research  Coordinator  Dashboard  

Find  Your  Study  (HUM#)  

Enter the full number including the leading zeros

Click accept

Research  Transac4ons  

Select Research Transactions from menu

Select “Transactions History” to view study account activity

Charge  Grouping  Selec4on  

Select patient from drop down menu

Review report by detail

Pa?ent  is  checked  

Acct  ID  where  you  will  find  the  checked  pa?ents  charges  to  the  study  account  

Account ID’s

This  is  the  account  overview  screen  that  will  appear  once  you  have  chosen  a  statement  to  review  

Account Overview Screen

Tabs  with  informa?on  regarding  the  study  account.      •  “Hosp  Tx  Inquiry”  tab  to  view  HC  charges  that  have  posted  to  the  account.  

•  “Prof  Tx  Inquiry”  tab  to  view  PC  charges  that  have  posted  to  your  account  

Inquiry Tabs

This  is  the  Hosp  Tx(Hospital  Transac4on)  Inquiry  screen.      §  Check  “Select  All  Groupers”  to  view  all  HC  charges  for  the  statement  you  are  reconciling.    §  Choose  a  charge  to  review  by  clicking  on  the  Svc  Date,  select  “Charge  Router  Charge  Detail”,  

Click  the  +  next  to  “Charge  Informa?on”  §  The  service  performed,  CPT  and  EAP(CDM)  codes,  the  date  of  service  and  the  pa?ent  

informa?on  are  available  here  

Hospital Transaction Inquiry Screen

Charge Routing Information Screen

§ When  you  are  done  in  the  research  statement  simply  click  on  the  “X”  on  the  open  tab  and  this  will  take  you  back  to  your  study  workbench.      

§  The  pa?ent  selected  will  automa?cally  reset.  

Exiting the Account

Helpful  Resources  §  CRAO  and  MBECT  Website    

hep://www.med.umich.edu/medschool/research/CRAO.htm  

§  Clinical  Research  Billing  Guidance  §  Unscheduled  Occurrence  Form  §  Charge  Correc?on  Request  Form  §  Frequently  Asked  Ques?ons  (FAQs)  §  MBECT  Training  Manual  &  Other  Related  

Informa?on  §  Research  Request  Account  form  (RMRN)  

Helpful  Resources-­‐cont’d  

§  The  CRAO  Chaeer-­‐monthly  newsleeer  § MBECT  Tips  &  Tricks  Weekly  Newsleeer  §  CRAO-­‐Mbect-­‐help@med.umich.edu  § MBECT  help  desk-­‐  764-­‐KNOW  (5669)  §  hep://www.med.umich.edu/i/michart/area/research.html  

§  CRBIssues-­‐help@med.umich.edu  § MiChart-­‐Research@med.umich.edu  

– Research  Applica?on  Coordinators  •  Exempt  study  crea?on  (RSH)  in  MiChart  

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Thank you!