Get the free General Information - Pennsylvania Patient Safety Authority

THE UNIVERSITY OF PENNSYLVANIA HEALTH SYSTEM RESEARCH BILLING VISIT FORM Attach a copy of this form to each test or procedure requisition form PATIENT & SCHEDULING UP: Patient Name: DOB: / / mmddyyMRN:

How to fill out general information - pennsylvania

How to fill out University of Pennsylvania Health System Research Billing Visit

1. Gather all necessary patient information, including name, date of birth, and medical record number.
2. Obtain the details of the research visit, including the date, time, and purpose of the visit.
3. Ensure you have the study protocol and any documentation related to the research billing.
4. Complete the billing form accurately, entering patient details in the appropriate fields.
5. Indicate the specific services provided during the research visit that require billing.
6. Verify that you have included the correct billing codes associated with each service.
7. Review the completed form for accuracy and completeness.
8. Submit the form to the designated research billing office at the University of Pennsylvania Health System.

Who needs University of Pennsylvania Health System Research Billing Visit?

1. Researchers conducting clinical trials or studies at the University of Pennsylvania Health System.
2. Patients participating in research studies who require billing for the services provided during their visits.
3. Billing department personnel who manage research-related billing and reimbursement.

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What is University of Pennsylvania Health System Research Billing Visit?

The University of Pennsylvania Health System Research Billing Visit is a protocol for billing research-related services that are provided to subjects participating in clinical research studies. It ensures that the appropriate billing processes are followed for services rendered during research activities.

Who is required to file University of Pennsylvania Health System Research Billing Visit?

Researchers conducting clinical trials or studies that involve patient interactions and services at the University of Pennsylvania Health System are required to file the Research Billing Visit.

How to fill out University of Pennsylvania Health System Research Billing Visit?

To fill out the University of Pennsylvania Health System Research Billing Visit, researchers need to complete the designated billing forms provided by the institution, accurately documenting services rendered, research subjects, and other necessary details as per institutional guidelines.

What is the purpose of University of Pennsylvania Health System Research Billing Visit?

The purpose of the University of Pennsylvania Health System Research Billing Visit is to ensure that research-related services are billed appropriately and in compliance with federal regulations, as well as to provide clarity on the costs associated with study participation for patients and sponsors.

What information must be reported on University of Pennsylvania Health System Research Billing Visit?

The information that must be reported includes the services provided during the research visit, identification of research subjects, date of the visit, consent status, and any relevant billing codes associated with the services rendered.