Clinical Research Billing Compliance

Overview

Johns Hopkins Medicine imparts a tripartite message in which Education, Research and Clinical Care are equally important and the cornerstone of everything we do. As such, the Institution has created an infrastructure to support research in a way that minimizes risks to the participant, to the staff conducting research and to the Enterprise.

“Effective for items and services furnished on or after July 9, 2007, Medicare covers the routine costs of qualifying clinical trials, as such costs are defined below, as well as reasonable and necessary items and services used to diagnose and treat complications arising from participation in all clinical trials.” (from http://www.cms.gov/medicare-coverage-database/details/ncddetails.aspx?NCDId=1&ncdver=2&fromdb=true)

This statement from Medicare’s Clinical Trial National Coverage Decision in conjunction with highly publicized Medicare settlements triggered the creation of a formal infrastructure to assure that Johns Hopkins Entities provide better support surrounding the clinical research revenue cycle.

The office of Clinical Research Billing Compliance was created in February of 2007 to prospectively manage hospital and professional fee patient care charges for federally insured research participants through a pre-billing review process on behalf of Johns Hopkins Medicine (JHM). CRBC is primarily a billing compliance office.

Liza

Clinical Research Billing Compliance (CRBC)

Sr. Associate Director: Liza Rodriguez
Email: [email protected]
Phone Number: 667-208-8898

CRBC ensures that patient care services for study participants are billed as either “routine care” [e.g., to the participant or his/her insurer] or “research only” [e.g., to be paid by the study budget / sponsor], using the Prospective Reimbursement Analysis as a roadmap. This “adjudication process” is carried out for hospital inpatient/outpatient and professional fee charges. CRBC is also responsible for regulatory monitoring related to clinical research billing. 

Billing Questions

Research participants or patients that have questions about their billing must contact customer service or their research coordinator

Resources

Helpful documents and weblinks associated with each group are available by category.