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RICO FAQs

 How are SOC procedures requiring submission of images to core labs managed?

  • There is no change to the current process. Outside departments are responsible for obtaining images and forwarding them as needed to core labs.

 Are rescans of SOC procedures repeated for research because they are outside of the study windows exempt from the charges and RICO submission?

  • NMH Billing is not affected by the RICO process.  SOC procedures repeated for research purposes will be billed per the established NMHC process with standard CPT codes as required for the purposes of the study.
  • RICO will have an initial fee for review, amendment fee for major protocol or budget changes, and additional support service as noted on the memo dated 11/10/21.

 Are the RICO fees required for NM and NU procedures – i.e. CAMRI/CTI and NMH MRIs?

  • RICO fees will be applicable to industry-sponsored studies utilizing Radiology imaging services at NMH. If the industry-sponsored study only utilizes Northwestern University core facility resources at CTI, the study will be referred to CTI to follow their registration process and scanning fees.

 Are these Northwestern Memorial Hospital or Northwestern University fees?

  • These are NU fees.

 Is overhead (indirect costs+ F&A) included in the fees or does it need to be added?

  • Our rates are not inclusive of overhead. Departments should budget accordingly for overhead.

 How will bills be managed/routed?

  • RICO will utilize NUCore for billing purposes. Charges will be reconciled on a monthly basis. Once the study is active and the chart string is generated, the finance contact listed on the competition's application will receive a monthly notification to review the charges listed.

 Will RICO provide detailed budget templates for Study Tracker entry?

  • We will provide a detailed study budget which will include all RICO associated fees and the imaging CPT codes. Departments will still need to create a study-specific detailed budget and include the imaging CPT codes provided. This process is unchanged from standard practice.

 What is included in the Raw Data/QC/QA fee?

  • The need for Raw Data/QC/QA is determined during the RICO evaluation process.  This will not apply to all studies and will vary from study to study.

 Studies frequently allow for MRI or CT depending on physician preference and patient tolerance. Are administrative fees applied to both tests?

  • NMH Billing is not affected by the RICO process. SOC procedures repeated for research purposes will be billed per the established NMHC process with standard CPT codes as required for the purposes of the study.
  • No, we do currently not have the authority to provide support at satellite hospitals.

 The attachment states: All standard of care imaging will continue to be billed by the hospital. Will research be billed differently if the same procedures. We receive the research bills via the same mechanism. Is this reflective of added charges above the hospital charges?

  • NMH Billing is not affected by the RICO process. SOC procedures repeated for research purposes will be billed per the established NMHC process with standard CPT codes as required for the purposes of the study.
  • RICO will have an initial fee for review, amendment fee for major protocol or budget changes, and additional support service as noted on the memo dated 11/10/21.
  • RICO will utilize NUCore for billing purposes. Charges will be reconciled on a monthly basis. Once the study is active and the chart string is generated, the finance contact listed on the competition's application will receive a monthly notification to review the charges listed.

 What is the expected turnaround time for study review/approval?

  • The expected turnaround time is 5-10 business days.

 For the training – who is being trained – NMH tech performing the procedure or other team members. Trainings are often read & review, which usually takes less than 30 minutes; how will this be tracked/billed?

  • This is for radiology technician training. Studies often require training for technicians prior to or alongside patient enrollment. The feedback we received from techs is that training for certain studies can take up to 3-4 hours. Technicians will report this effort to RICO monthly, charges will be billed to the study via NUCORE and NMH will invoice RICO for reimbursement.

 Will RICO facilitate trainings and obtain ongoing regulatory documents for assigned radiology personnel(i.e., CVs, ML, HSP)??

  • No, outside departments are still responsible for facilitating training and maintaining regulatory documents.

 If required by the study, will RICO support assignment of a radiology physician lead to add to Delegation of Authority logs and IRB?

  • If a radiologist becomes a Co-Investigator, per IRB rules that person would be added to the IRB study and to DOA logs. Through the RICO evaluation process, the review committee will help identify a radiology Co-Investigator if deemed appropriate/necessary for each study.

 Does a single submission facilitate support across all NMHC institutions – i.e. Lake Forest, CDH…

  • No, we do currently not have the authority to provide support at satellite hospitals.

 For multiple studies with one sponsor using the same scanning protocol – are we subject to review/RICO submission for each study – very burdensome for the research team

  • Yes, each study will require RICO review. If certain additional support services are not required due to the same scanning protocol being used, those fees will not apply.

 What is a research analysis report? A physician read? If so, why is this charge per hour instead of per report?

  • RICO determined an hourly rate was most appropriate due to the varying needs of each study.
  • Fees for the analysis report would cover NU personnel as they would be performing this work. These fees will only be charged where applicable. A few for this additional support service fee:
    • A standard clinical read is required for the study à Standard workflow via Epic would apply à the read will be billed via standard CPT code and included in the letter of support provided to the outside department. No additional research analysis fees will apply.
    • A study that includes a Radiology co-investigator with percent effort requires an additional or non-standard of care read, meaning study-specific information/requirements are needed à Fee for research analysis report will not apply because this work is accounted for in the Radiology co-investigator's effort for the study.
    • A study without a Radiology co-investigator requires a non-standard read à Research analysis report will apply and the fee will be listed on the letter of support provided to the outside departments.

 How are same procedures managed if completed via radiology and outside radiology? – carotid stents are one example

  • The RICO evaluation process only covers radiology services. This will not impact how work is done in outside departments.

 What is the expected turnaround time for phantom scans? There has previously been longer waits to get these to be completed.

  • To be determined and will depend on the availability of scanners due to the clinical schedule being a priority. We expect the RICO process will improve turnaround time.

 The Study Intake Form is extensive- the study information is included in the protocol, the imaging information is typically not clear to the non-radiology personnel – can RICO assist as part of the administrative fees?

  • We understand the intake form is extensive, but the up-front effort will streamline the review process and generation of the detailed study budget. Currently, the study intake process is not standardized and centrally managed which has led to significant delays for prior imaging studies. We anticipate that the new RICO process will increase intake efficiency and reduce workload for all departments utilizing radiology imaging services and NMH. RICO staff will also assist in the completion of the intake form.

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