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Finance and Contract Pre-Award Process Rachel Sheppard Regulatory Director, OCRSS.

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Presentation on theme: "Finance and Contract Pre-Award Process Rachel Sheppard Regulatory Director, OCRSS."— Presentation transcript:

1 Finance and Contract Pre-Award Process Rachel Sheppard Regulatory Director, OCRSS

2 Protocol solicitations No standard methods NDA Site questionnaire Synopsis

3 Site Qualification Sponsor evaluation of site Tour of facilities Meeting with personnel Know processes and timelines Sometimes by phone

4 Feasibility Formal review Get all information Be prepared (document review) Schedule of Events Inclusion/exclusion Budget template ICF template CTA Lab/imaging manuals Real logistics

5 Billing Compliance Table Billing plan Specifies the coverage of procedures Providers use to bill for procedures performed Must match with contract, budget and ICF

6 Billing Plan Development How do you determine standard of care? a. PI determination b.Review of previous orders c. NCD/LCD d. Sponsor proposed

7 Budget Development Price requests from hospitals/clinics CPT codes Professional fees Associated charges Detailed descriptions Time estimation Coordinator time PI time Internal budget grid

8 Best practices Assume that the budget template is incomplete Base all fees on actual activities/costs Involve clinical and regulatory in analysis

9 Budget Negotiation Most are negotiable A game Know when to change tactics Information is power Have standard methods/rationale

10 Contract Review Process Submit TRIA early Report all non-U of L personnel Be detailed Communicate with stakeholders Hospital offices Negotiator Sponsor

11 References OIG Compliance Program Guidance for Third-Party Medical Billing Companies (1998) eXL Pharma


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