Clinical Research Payment Network’s Post

Negotiating a great budget is awesome. It feels good. Feels like you won. What's even better: -knowing what actually triggers a payment -knowing exactly when payments are being prepared, processed and sent -knowing exactly what you got paid for in a way that matches the negotiated budget -not being forced to invoice the sponsor for every little thing when they know what procedures/assessments have been completed -an actual, consistent human contact that you can reach out to and not a generic invoice/payments inbox Sites are businesses and should be treated as such. I'm convinced that one the biggest actual impacts we could make in clinical trials is funding sites so that they can do they work that they know how to do. #clinicaltrials #clinicalresearch

…”actual, consistent human contact that you can reach out to and not a generic invoice/payments inbox.” An invoice was sent in September 2022 - fast forward to September 2024, the site still hasn’t received payment. Ongoing email correspondences between CTP and site with an email yesterday to site: “To make things easier and more efficient, could you please fill out the attached form? This will allow us to grant you access to the portal, where you can quickly and accurately obtain remittance details for all payments.” At this point, I can confidently say the system is broken. The human aspect is crucial, and very much appreciated even though it’s yet to be offered or accepted.

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The Patient Choice and Review Panels (PCRs) are starting to gain traction. This week, we received a report of the first referral to the Independent Patient Choice and Review Panel regarding a tendering exercise. It is crucial to highlight that, unlike the 2015 PCRs where only interested parties such as unsuccessful tenderers could utilise the challenge processes, the new PSR allows any individual or company to refer a decision to the Panel if they have concerns. This change ensures a more transparent and inclusive process for all stakeholders involved.

Speaker Highlight for the upcoming HFMA Fall Conference. Payor Down Coding, presented by Susan Rohde. Starting in January 2021, the American Medical Association (AMA) created new Evaluation and Management (E/M) guidelines to reduce the documentation burdens placed on providers. Following the changes, several payors began implementing algorithms, within their systems, that inappropriately down coded claims, causing payment reductions. To the frustration of providers, payers are increasingly implementing E/M down coding programs that inappropriately reduce payment for claims billed. Often, these reduced payments, go un-noticed, as staff is looking for full denials, and not claim payment reductions. Learning Objectives: Learn how to discover if your claims are being paid at a lesser value than what was submitted (down coded) Understand how to appeal these claims with sample appeal letters Issue tips for educating providers on key documentation guidelines to avoid payor down coding. More Details/Register: https://lnkd.in/gJJ2MFvE

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Do you want to learn more about Clinical Payment Process? Download this white paper by HERAX.