The UF Office of Clinical Research (OCR) Coverage Analysis and Budget (CAB) team performs Coverage Analysis on all new Human Subjects Research studies submitted to OCR.
Coverage Analysis is the review of study documentation to determine who will be paying the costs of each item, service, and activity required by the protocol. This analysis and determination results in a study-specfic billing plan, which is recorded on a billing grid in OnCore and Epic, as applicable.
OCR Coverage Analysis Workflow
For studies that will have services billed to study subjects/insurance, Coverage Analysis is a three step process:
- Confirm that the study meets the definition of a Qualifying Clinical Trial
- Determine which study-related items/services may be considered to be Routine Costs
- For each Routine Cost, document the Medicare rule(s) that allows reimbursement for that item/service and any other rules that disallow or reduce coverage for that item/service.