Clinical trial patients how do you handle billing and coding

Specialties Research

Published

I am working as a clinical trial RN coordinator in oncology. Previously my role was to screen pts for eligibility, enroll them and be a patient navigator and manage trial protocols with physicians throughout a pts care. We now are being asked due to trouble with reimbursements to review every patient that is flagged as a clinical trial pt, for all visits (trial or non-trial) send out notifications to all departments for what is trial related what is not related, what is paid by the trial vs standard of care and what the Z codes and Q modifiers are for all services a pt received. I am very frustrated because it is taking up huge amounts of time, away from the thing I enjoy most about research, the patient. I was told that this is a common process for research sites, so I am wondering who else out there is a coordinator and how is your department handling billing and coding?

Specializes in Nursing Education, Research, ENT, Oncology.

Dealing with bills is one of the worst parts of a research nurse coordinator role.

Having patients registered in portals that both hospital billing and research billing have access to (such as Velos) can help intercept some of the charges.

I have learned that announcing surgeries on clinical trial patients via email ahead of time helps give departments the "heads up" that helps us on the front end, rather than cleaning up messes.

Sharing the budget worksheet that is used for each specific trial can also help. And finally, within our department, when we schedule research patients, we would put in "bill to research study."

I hope this helps!

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