Clinical Research Billing Compliance Summit 2025

According to the American Hospital Association claim denials have surged by an average of 20.2% for commercial plans and 55.7% for Medicare Advantage plans. Are you struggling with denials in your clinical trial billing program? Join Joe and Richard to hear how to work through the denials and not break your bank!

• Understanding common reasons for hospital claim denials
• Developing strategies to improve claim approvals for research claims
• Analyze complex insurance regulations affecting hospitals

Evaluate your connected technology ecosystem 
Understand why system integrations are crucial for financial management
Propose running your research site as a business.

With a career spanning 40 years, Dr. Milner has been a great supporter of clinical research and clinical trials, a champion of innovation, and serves as an advocate for long-term strategic business development that supports the best in healthcare. Retired from Yuma Medical Center in September, Dr. Milner reflects on what she learned, and how to harness that with your team daily.

🌐 Navigate your CEO to understand the world of billing compliance
⚖️ Engage in a practical examination of the advantages, limitations, and diverse range of billing compliance issues in a large medical center
🔍 Explore and gain valuable insights to boost productivity and enhance your team's compliance.

This presentation will cover the overall benefits of performing a Medicare coverage analysis (MCA), including important criteria to consider during MCA with emphasis in ensuring the success and ethical integrity of oncology clinical trials. We'll discuss coverage analysis billing compliance with regulatory requirements and patient access to innovative treatments.
Using real-life examples, participants will learn skills to perform a coverage analysis, how to navigate reimbursement challenges, and the importance of fostering collaboration between stakeholders. If you are involved in oncology clinical research, this session will provide valuable insights for optimizing trial design and execution.

• Learn the role of coverage analysis in oncology trials
• Examine Medicare's national and local coverage determinations, coding and billing requirements, and more
• Discuss best practices for navigating reimbursement challenges in oncology trials
• Address billing compliance issues for complex oncology trials

Proper compensation for physicians involved in clinical research is critical to their engagement and retention. 
This session will discuss how to fairly compensate physicians while maintaining ethical and regulatory requirements.


🔬 Understand the regulatory risks that arise with physician compensation
💼 Discuss options for structuring compensation for research
🎯 Explore the physician's view of the compensation challenges that arise within research

In this illuminating session, two WCG experts will delve into actionable strategies for expediting study activation within the NCIs recommended 90-day study start-up timeline. Attendees will gain insights into how operational silos during study activation adversely impact start-up timelines and compliance, slowing progress and potentially
jeopardizing study outcomes. By exploring a more streamlined and integrated approach
to study initiation, we can improve trial efficiency and improve patient care.

 Proven strategies for accelerating study activation within the NCI's recommended
90-day start-up timeline.
 How to fix silos in your study activation before they impact your timelines and
compliance.
 The effects of study activation processes on participants.

This session will provide an overview of billing compliance policies and procedures in place at Parkview Research Center. By the end of the session, you should have an increased insight into which policies and procedures may benefit your institution. You will also learn effective strategies for implementing these practices into your research program.

1. Analyze what policies and procedures our institution implemented and why we have these practices in place
2. Understand why implementing policies can keep your institution compliant
3. Clarify what policies would be good for your institution.

Accurate coding and claims processing are crucial for compliant research billing. The coverage analyst plays a key role in communicating the coding and billing requirements for specific studies. This session will explore Medicare bundled payment systems and the impact of coding on hospital payments and research billing.  

📁 Learn what MS-DRGs are and the Inpatient Prospective Payment System bundling methodology.
💡 Understand APCs and the Outpatient Prospective Payment System bundled payment methodology.
📈 Discuss real-world examples of complex studies and potential overpayment risks.