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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 § [email protected]
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-‐[email protected]
§ 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-‐[email protected]
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:
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
[email protected] § 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-‐[email protected]
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-‐[email protected]
§ If you would like to speak to the CRB Lead, call 998-‐6569
Steps to Reconcile Your study account
Submit'to:'[email protected] 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 [email protected]
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-‐[email protected] § MBECT help desk-‐ 764-‐KNOW (5669) § hep://www.med.umich.edu/i/michart/area/research.html
§ CRBIssues-‐[email protected] § MiChart-‐[email protected]
– Research Applica?on Coordinators • Exempt study crea?on (RSH) in MiChart
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Thank you!
