Financial Management Software Application

Financial Management Software Application Clinical Trials Operating System (CTOPS)

Medicare published a National Coverage Decision (NCD) on Clinical Trials in 2000 with the goal of encouraging more of its beneficiaries to participate in clinical trials.  However, complexities and ambiguities in the NCD on clinical trials have presented significant compliance challenges for healthcare providers.  For example, each clinical trial must be uniquely analyzed to determine which items and services are billable to Medicare.  In clinical trials, this means that the provider must establish a process to analyze many services and items over the course of their treatment.  Effectively, this results in high risk for “double-billing” or other billing errors.

In addition, the Federal government is viewing clinical trials as a high-risk area.  At a recent Healthcare Compliance Association meeting, fraud in clinical trial billing was identified as one of six top enforcement priorities.

Currently, there are 389 hospitals of 250 beds or more that conduct at least 5 clinical trials annually.  In addition, 18% of all board certified physicians serve as Investigators on clinical trials.  Procedures for accurately tracking and billing research related charges must be in place whether providers conduct one or a thousand clinical trials per year.  

Compass Point Research has developed, customized and implemented Clinical Trials Operating System (cTOPS™), supporting over 50 institutions Nationwide.  cTOPS™ is a proprietary web-based software application to track and adjudicate research activity as the patient travels through multiple touch points within the healthcare organization.