Protocol Visit Payment Reconciliation
Sponsors and CROs claim that protocol visits are paid automatically, but when we run an analysis, we find that visits are often missed by the CRO payment process, checks may be authorized but not paid, retainage is not calculated properly, etc. We are an advocate for our clients, who face a complicated process. Knowing which visits have been paid and what to include as Accounts Receivable requires attention to detail, starting with the proper system set up, then managing the system to know which visits have been completed by reconciling payments to ensure that each visit has been paid. Increasingly, CROs and sponsors require invoices to be submitted in their own system. This is a time-consuming task for site staff that should be focused on research and recruiting.
Invoicing for Extra Procedures
Clinical Trial Agreements include extra procedures that are reimbursed subject to invoice. That invoice must include very specific data and, in some cases, supporting documentation. Most sites do not track all extra procedures and thus leave this money uncollected. Sponsors and CROs are aware of this and pay visits automatically but not extras. Our proposal to the site is to help them to collect these funds, thus it is “found” money for them. Our experience has shown that these extras can become a significant percentage of revenue. Depending upon the therapeutic area, we have seen invoiceable items run from 10% to 50%.
We help sites to negotiate study budgets to ensure that overhead is adequately charged, per patient budget amounts cover costs, and all potential extras are included in the agreement. We work with the site to develop an Overhead and Charges Policy to explain the overhead rate and fees. Each site has specific requirements. Our participation in budget negotiations and our ability to collect extras increases site budgets by significantly more than the cost of our fees. We believe that the work that sites do is important and should be compensated fully. It is important to keep independent research sites strong and financially healthy.
Our services are oriented toward negotiating budgets that fully capture site costs and ensuring that all contractual items are invoiced in a manner that will significantly increase revenue to the site and thus strengthening the financial position of the research site. The net income falls straight to the bottom line for the research centers.
Additional benefits to sites of using a CTMS:
Accounts Receivable for Clinical Trial Sites
Sites need to know how much work has been done in visits and extras, how much has been paid and how much is pending payment (A/R). An aging of Accounts Receivable shows what has not been paid and thus who needs to be called to collect. We follow up on unpaid invoices monthly. This is a major weakness in most site operations. Without active A/R management, sites fail to collect a considerable portion of reimbursement for work completed.
Accrual financial revenue gives management more realistic insight into the site’s financial activity and health. We can generate monthly financial reports that track accrued revenue, payments, accounts receivable, broken down by visits, invoiceables, retainage and screen failures. This provides a useful management tool that is difficult to extract directly from the system. This can be used to support bank financing or valuation in the sale of the company.
If you are seeking to sell your site, the valuation will be higher and financial due diligence much easier with a fully functional CTMS. The financial reports form an important part of the valuation process. We can help with Business Plan preparation and financial valuation.
Analytical Reports for Site Management
We prepare reports for management that help to indicate the financial health of the business. Clinical research is especially challenging to manage because studies begin and end, screening is more profitable than maintenance, trials can be terminated – the site can be understaffed or overstaffed. Analyzing information from the CTMS gives insight to the direction of the business – without it, many sites lack critical information for operational insight.
Accrual Basis Reports
Financial statements on accrual basis rather than cash basis. Most sites run cash basis because they do not understand the benefits of presenting financial statements on an accrual basis. We can provide revenue reports on both accrual and cash basis. An accountant can use these reports to convert the financial statements from cash basis to accrual basis;
At your invitation, we will come to your site to audit study payments prior to close-out. We will review all payments, visits, extra procedures, and contractual commitments. Unpaid items will be invoiced, with full supporting documentation. We will then follow-up with the sponsor/CRO to ensure the site is paid.