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University of Nebraska Medical Center

Clinical Research Billing

About Research Billing:

Research billing is the process in which hospital and professional charges for research participants are routed to the correct account and billed appropriately and in compliance with relevant laws, regulations, and institutional policies.

It allows for adherence to Centers for Medicare & Medicaid Services (CMS) National Coverage Determination (NCD) 310.1, also known as the Clinical Trial Policy.

Why is Research Billing Required:

Prevents Health Care Fraud, such as:
Double billing: Submitting multiple claims for the same service.
Phantom billing: Billing for a service visit or supplies the patient never received.
Unbundling: Submitting multiple bills for the same service.
Upcoding: Billing for a more expensive service than the patient received.