If appropriate, use a generic statement: “All clinical care in this study is billed to the patient,” or “ No clinical care in this study will be billed to the patient,” or “ Clinical management of surgical procedure.Managing a construction project is not a simple task.Use Comments section as required to provide clarification, especially if the same service is also listed on the RPS form (e.g., if “clinic visits” are listed on the RPS Form and on the Routine Care form, indicate the number under Occurrences per Participant and list the associated time-points under comments such as “6, 12, 24, and 36 months”).Enter number of Occurrences per Participant per Study Period.Using the protocol’s Schedule of Events as a reference, list in the Service Description section all clinical services to be charged to the study subject’s insurance as part of routine care.The top section of this tab will auto-populate from the RPS Form. The study team has deemed items on this tab as routine care, chargeable to the patient/patient’s insurance. If uncertain, discuss with your RMG institutional official during the budget development process. For example, click on the Medicare Determination question hyperlink to be taken to the decision tree tool to determine if this is a Medicare National Coverage Determination (NCD) Qualifying Study. Step 1: Provide basic study information in the upper section of the form. Identifies the patient care services that should be billed to the study account as a research and not to the patient/patient’s insurance as standard of care.Whether the study meets Medicare CT Policy criteria.The RPS Form provides key billing information to the hospital Patient Financial Services (PFS): ![]() Tab - InstructionsĬomprehensive instructions on how to complete the Workbook and a great resource when questions arise! Tab - Research Participant Services (RPS) Form Below is a brief description of each tab or worksheet. ( See Instructions Tab in Workbook).Įach tab serves a different purpose in the budget and billing process. ![]() Form updated as needed by study team post-Award. Not applicable – see details within Billing Gridįor all studies, completed by Study Team post-Award and Patient Financial Services.( See Instructions Tab in Workbook).įor all studies, top section is auto-populated by RPS form. IMPORTANT: For pediatric studies that will enroll adult patients at SHC, study will require Ankura Coverage Analysis (CA) and the SHC Modified Workbook will be used. PI’s approval of CA is required.Īlways work with the current workbook downloaded from Spectrum website. Used for all NEW studies with clinical services rendered at SHC and/or Stanford’s CTRU Workbook includes formal Coverage Analysis (CA).
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