Are Clinical Trial Sites Leaving Billable Items on the Table?


Bonnie Segal, vice president of Segal Institute for Clinical Research

A growing number of billable items are not automatically included in contract agreements between study sites and sponsors, says Bonnie Segal, vice president of Segal Institute for Clinical Research. The upshot? Sites often leave money for a number of billable activities on the negotiating table, she says.

“When it comes to negotiating a contract on behalf of a site, there’s no room anymore for someone who is not on their game,” Segal says. Her Florida-based organization is an 18-year-old group of six sites with some 70 full-time research staff on board.

Example: Subject transportation. After trying to rely on subjects making their way to the site via public transportation or their own cars, Segal saw retention rates go through the roof when she hired drivers and a van service to handle much of the travel services. However, many sites don’t think to get that cost in the billing agreement, and sponsors certainly won’t suggest it themselves. Instead, Segal’s team negotiates upfront for the sponsor to cover that cost. “We get it back about 90% of the time,” she says. “You’ll never get it back if you don’t ask.”

Another example: Psychiatry and neurological trials. It’s become more and more common for a rater training company to be involved in a clinical trial, she says. Sites should also address the costs of certification before they sign anything, she says.

Technological tools also represent an overlooked billing arena. Segal suggests building in some sponsor funds to cover things like glitches (e.g., a patient using an iPad remotely says it has crashed). “You’re going to have to pay some kind of tech support and hour or so every time something like that happens,” she says. Historically, sponsors have not covered some of those costs. Again, you have zero chance of getting reimbursed for that if you don’t ask.

Additional Resources

For more information, check out the October 2015 issue of ACRP’s Clinical Researcher journal, which includes a variety of articles on topics tied to clinical trial billing.

To learn more tips for building and negotiating trial budgets, check out Mastering Budgeting at Your Site: Building and Negotiating Trial Budgets that Make Sense.

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