Budget and Billing Workbooks
SHC Coverage Analysis Workbook and SCH (LPCH) Budget and Billing Workbook
Please note that Stanford Medicine Children’s Health (SMCH) and Stanford Health Care (SHC) use different workbooks. Each hospital has a specific version of the Workbook that captures the costs of services performed at the respective hospital, regardless of patient age. Each workbook has pricing and coding information specific to the location where the patient care services will be performed.
What is the Budget and Billing Workbook (commonly referred to as the Workbook) and why is it important?
- An Excel workbook used by hospital's Patient Financial Services (PFS) for clinical research studies with patient care services to process all hospital fees as either: (1) billable to the research study account, and thus, paid for by the sponsor, OR (2) billable to the patient/insurance
- Workbooks are used by CT RPMs to estimate hospital costs within Stanford's per patient budget
- A required Minimum Document to initiate the study set-up process for an Industry-Sponsored Clinical Trial (CT) conducted at SMCH
- CONFIDENTIAL internal document not shared with sponsors
In addition, the Workbook provides other benefits:
- Prevents major compliance issues like double-billing (i.e. billing both the sponsor and a patient/patient’s insurance for the same item)
- Helps study team accurately manage study patient charges, as per contract, from enrollment through closeout
- Ensures Medicare Clinical Trial Policies are followed
Policy
Who Completes the Worksheets within “Workbook” for Industry-Sponsored Clinical Trials?
Workbook Tab template used: | SHC Modified CA Workbook Used for all NEW studies with clinical services rendered at SHC Workbook includes formal Coverage Analysis (CA). PI’s approval of CA is required. |
SHC Workbook Used for all NEW studies without protocol required SHC clinical services, including studies conducted only at CTRU or data collection studies etc. |
SCH (LPCH) budget and billing workbook Always work with the current workbook downloaded from Spectrum website. IMPORTANT: For studies that will enroll both pediatric subjects with clinical services required at LPCH and adult subjects with clinical services required at SHC, study will require Coverage Analysis (CA) and it will be used to prepare to the LPCH workbook. |
Qualifiy Clinical Trial Analysis | Huron (SHC CA Consultants) | Not represented as a separate tab - if required work with CT RPM to document within RPS form. | Not represented as a separate tab - if required work with CT RPM to document within RPS form. |
Billing Grid | Huron (SHC CA Consultants) & CT RPMs | Not applicable | Not applicable |
Central Office Only Budget Grid | CT RPM | Not applicable | Not applicable |
Research Participant Services (RPS) form | Not applicable - details included within Billing Grid | Study Team | Study Team |
Routine Care Form | Not applicable - details included within Billing Grid | Study Team | Study Team |
Study Account Request Form | For all studies, completed by Study Team post-Award and Patient Financial Services. (See Instructions Tab in Workbook). |
||
Study Enrollment Form | For all studies, completed by Study Team post-Award and Patient Financial Services. (See Instructions Tab in Workbook). |
||
CITI Cert Form | For all studies, completed by CT RPM. |
Summary of tabs within the SCH (LPCH) Budget and Billing Workbook
The Workbooks have several labeled tabs. Each tab serves a different purpose in the budget and billing process. Below is a brief description of each tab or worksheet.