Offices, Leadership, and Additional Information
Sr. Associate Director: Liza Rodriguez
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.
Supervisor, Access Services: Kula Sonii-Jones
Phone Number: 443-997-5037
CRFC staff verify insurance coverage of potential participants for outpatient studies and coordinate alongside JHM Access Services to obtain inpatient services clearance. Participants with Medicare have a defined clinical trial coverage benefit. Some insurers will refuse to pay for routine care provided in the context of a clinical trial. The Informed Consent Form of a study with a PRA explains “what will it cost” to participate in the study by referencing the Patient Financial Responsibility Information Sheet. As a result, verification prior to enrollment whether a participant’s insurance will authorize coverage is an essential element of the clinical research financial clearance process. CRFC also provides guidance for the appeal of clearance denials for routine services associated with clinical trials.