Clinical research billing compliance is one of the most challenging areas in healthcare compliance, involving multiple departments, stakeholders, skillsets, processes, and regulations in a complex healthcare environment. The clinical research billing compliance process begins with the Coverage Analysis (CA) and culminates with verification that the claim was submitted and paid for by the correct payer. Maintaining audit readiness is key to mitigating risk. This session will:

• Highlight the clinical research billing rules, the power of a thorough CA, and best practices
• Discuss charge segregation and application of correct codes, modifiers, and identifiers to claims, as well as common billing errors, omissions and challenges noted in audits conducted across the multiple organizations
• Review example claims against the coverage analysis and the billing rules including Medicare Advantage 
• Identify methods to conduct successful clinical research billing audits and maintain audit readiness including best practices such as scoping audits, conducting internal audits versus getting expert assistance, building relationships with research stakeholders, and more…