Mount Carmel Health System

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Budgeting and Payment

The contact person for Mount Carmel Finance is listed on the Research Request Form. It is imperative that investigators make contact with this individual if any of the services provided by the health system will be paid for by the sponsor. The Finance contact will assist the investigator with budgeting for the cost of the services.

Once the study has received IRB approval to begin, the investigator will need to use the Study Patient Form.

The purpose of the Study Patient Form is to identify and track any patient who comes in for testing/procedures related to a research protocol. This also applies to patients who are currently hospitalized and are placed on a research protocol.

The Study Patient Form is completed in the office or when the testing/procedure is ordered. The form, once signed by the physician, is the prescription for the tests/procedures indicated on the form.

The patient will bring the form with him/her at the time of registration. Information provided on the form instructs the registrar on how to assign the insurance. If the tests/procedures are being paid for by the pharmaceutical sponsor, the billing assignment would be to an insurance bucket established for research. By assigning the research insurance bucket to the claim, the claim will be "kicked out" of the system and charges related to the research study and/or paid for by the pharmaceutical sponsor will be pulled from the patient's bill. The charges are then sent to the pharmaceutical sponsor for payment.

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Mount Carmel Health System  |  Columbus, Ohio

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