A framework for workflow-based clinical research billing disambiguation

Medicare received authorization in 2000 to reimburse for routine costs incurred in association with patients participating in clinical research. However, we hypothesize that the inability to accurately differentiate standard from investigational care has resulted in under-coding of potentially reimbursable clinical events. To address this problem, we have initiated the development of a methodology for constructing computational clinical workflow models that can be employed to aid in the disambiguation of routine versus research costs.