6/28/20161 Research Billing Collaborative Research Billing Initiative

6/28/20162 Agenda Revenue Cycle –Revenue Cycle Overview Patient Financial Services/Billing and Collections –Our Mission –Meet our team Feedback from previous process proposal and presentation Overview of the updated process –Updated process overview –Policy Overview –Effective Date Questions

Revenue Cycle Services Revenue Cycle Operations Patient Financial Navigation Scheduling/Registration (Schedistrar) Financial Clearance: Insurance Verification, Pre- Certification and Medical Necessity Point of Service Collections Individual Solutions Revenue Management Charge Description Master Business Intelligence Health Information Management, Clinical Documentation and Coding Admission Status Determination Utilization Management Clinical Documentation Medical Records Coding Discharge/Not-Final-Billed Accounts Billing and Collections Claim Submission and Follow Up Collections and Remittance Processing Denials and Underpayments Agency Management Patient Account Management Customer Service Support Self Pay and Financial Assistance 6/28/20163 Business Partner SupportRevenue Cycle Application Support

What is our mission? IU Health Mission: To improve the health of our patients and community through innovation and excellence in care, education, research and service. RCS Mission: To optimize Indiana University Health revenue while delivering on our Promise of Assurance. 6/28/20164

5 Revenue Cycle Services Research Billing Support Your Revenue Cycle Services Research Billing Partners  Lindsay Skowronski - Executive Director, Revenue Cycle Services  OPEN –Manager, Research Billing Manager  Trenia Logan, Team Lead Research Billing  Diane Mohler – Manager, Radiology Charge Services  Michele Wann – Manager, Pricing Estimation  Emily Dunkin – Program Director, Charge Integrity

6/28/20166 Thank you We appreciate your feedback and want to meet your needs as a business partner. This is what we heard: 1) You expect responsiveness from any Revenue Cycle ServicesTeam 2) You want to understand the process, at a high level, and know what to expect from this transactional relationship. You also want to know who to contact when you need answers, timely. 3) There are redundancies with the existing processes, and ideally we mitigate this as much as possible 4) The goal is to build strong foundational relationships with Revenue Cycle Services that lend to improved compliancy, while ensuring a positive patient experience at IU Health

Let’s Make This Successful We ask that you thoroughly review this updated process and reiterate with all staff adherence to this process is a compliancy requirement Ensure your department and staff follow these agreed upon guidelines/processes, and all new team members are oriented to this material Most importantly we are asking that you *We’ve made significant efforts to create a seamless process, reducing unnecessary exchanges and delays, so we kindly ask that you disregard previous material, presentations, and processes following the effective “go-live” dates discussed today – referring to this process as the standard on a go-forward 6/28/20167

Research Billing Packet Form #1 Research Billing Notification Form Applies to: All IU Health patients participating in a research study, grant study program, or clinical trials, regardless of who is fulfilling billing and collections efforts Required Submission Timeframe: As soon as an IU Health Team member is aware a patient will be participating and has the information available to complete this form, at a minimum two weeks prior to care delivery Anticipated Response: from IU Health Research Billing Team member acknowledging receipt, within within two business days Form #2 Research Registration/Grant Charge Form Applies to: IU Health patients, identified for completion and submission of Form #1, in which billing services are to be fulfilled by IU Health Revenue Cycle. Required Submission Timeframe: As soon as service/charge information is available to complete this form, at a minimum two weeks prior to care delivery. Anticipated Response: Return of completed form with the IU Health Billing Account Number Added, within two business days Form #3 Required Documentation for Research Supplies, Implants, and Investigational Device Exemptions (IDE) Applies to: IU Health patients receiving supplies, implants, and/or Investigational Device Exemptions (IDE) as part of the associated research study or Clinical Trial. Required Submission Timeframe: As soon as all components of the form are completed, including supporting cost information. Will require a minimum of two weeks, and be completed before the first patient’s service. Anticipated Response: An acknowledgement with the associated MedAsset Number within within two business days. Additional notifications will be sent when requests are approved and completed.

Billing Packet Process Overview 6/28/20169 Patient Identified for participation in any research/grant/clinical trial, etc. Research Billing Packet completion is initiated, including submission to IU Health Revenue Cycle Services Complete Form #1 (Research Billing Notification Form) regardless of billing onus Will IU Revenue Cycle Services be billing for services or charges associated with this service? YES Complete Research billing form #2 – submitting to IU Health Revenue Cycle Services Skip completion and submission of Research Billing Form #2 NO Will the patient receive any research supplies, implants, or IDEs YES Complete Research billing form #3 – submitting to IU Health Revenue Cycle Services Skip completion and submission of Research Billing Form #3 NO Process complete for Required Documentation of Research Supplies, Implants, IDEs

6/28/ Monthly Clinical Trial Participation Form This form is sent in addition to the Research Billing Packet, where applicable, and used to keep track of those patients that are in the clinical trials. Send form to: Also send at end of every month only if there have been changes to the sample (additions or removals).

What You Should Expect Upon Submission of These Forms With all submissions of completed forms you will receive a confirmation of receipt within 48 business hours. 6/28/201611

6/28/ Quick Reference Tools – All forms are located at : trials/clinical-trials-industry- partners/iuh-research-billing/ trials/clinical-trials-industry- partners/iuh-research-billing/

For all Pricing Estimation Inquiries Please note- all pricing inquiries, both professional and facility charges, should be sent to –Please specify “Pricing Request” in the subject line 6/28/201613

6/28/ Quick Reference Sheet StepForm AddressWhen to SendResponse Time 1 Research Billing Notification Form 2 weeks prior to trial start date Anytime a form is sent to the a response will be provided within two business days Research Registration/Grant Charge Form Copy if there is a radiology Initial: Within 24hrs 2Documentation Requirements for Supplies, Implants, or IDE Clinical Trials 2 weeks prior to trial start date 3Monthly Clinical Trial Participation Form 2 weeks prior to trial starting 4Monthly Clinical Trial Participation Form the end of every month if patient mix changes 5Investigational Device Coverage Form (Time of Service) of Service Submission implies receipt and processing,response should not be anticipated unless there are outstanding needs or questions

FAQ Q: Are we still using the fax number previously associated with this process? A: No. Please discontinue any use of Rfax, fax, and/or personal , as part of the Research Billing Processes Q: If prior versions of forms have already been completed, including submission, do we need to complete a new one? A: No. Please “cutover” where appropriate with use of the new process. However, any initial submissions of Research Billing Form #1, Research Billing Notification Form, will be declined with notification of such and reference to the new process Q: Is completion of this process required where billing is not fulfilled through IU Health Revenue Cycle? A: Yes. With provision of this information, onus of subsequent compliancy issues attributed to non- submission of these documents will be addressed with associated research personnel, where appropriate Q: What specifically does “supplies” pertain to? A: IU Health Revenue Cycle should always be made aware when supplies are provided at no or reduced cost, to avoid billing insurance or patients errantly for those services. Where this is known or suspected, notification is required. 6/28/201615

6/28/ Questions?