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Ethical Considerations Paying Subjects

Timing Is Everything: Why You Need to Reimburse Subjects Promptly

• How to Handle Travel Reimbursements to Subjects for Clinical Trial Participation - Nimblify Payments

By Kristina Lopienski
May 16, 2017

Paying clinical trial volunteers is a common and long-standing practice intended to allow patients the ability to participate in clinical research without suffering financial hardship. Payment often takes the form of reimbursements, which refund out-of-pocket expenses directly related to study participation, such as transportation, meals and lodging. Reimbursements typically require documentation, such as receipts, to get patients back to a cost-neutral state.

[Related article: Stipends vs. Reimbursements: Which is Best for Paying Research Subjects?]

Despite efforts to cover the costs of participation, the amount of time it takes many research organizations to handle reimbursements may prevent some patients from completing a study. Additionally, how you pay subjects may cause them to go further into debt. For all that patients sacrifice to participate in a study, the least we can do is pay them back promptly.

[Related article: Paying Research Volunteers: How to be Patient-Centric]

The need to speed up payment timelines to participants

The traditional method of paying participants is cutting checks. Though an antiquated form of payment, it’s still prevalent today. While some patients may like paper checks, it often prevents them from receiving their money in a timely manner. In fact, it can delay payment by four to eight weeks. This can be inconvenient and frustrating if there’s uncertainty around when subjects can expect to be paid, especially for those who struggle to pay their bills on time and depend on that money to get by.

In a world where rent is due monthly, credit card cycles are 30 days, and employees are paid bi-weekly, timely reimbursements to participants should be the norm and not the exception.

[Related article: Beyond the Check: Offering Options for Patient in Clinical Research]

Failing to quickly reimburse participants for their expenses after they have been incurred can exclude lower-income patients from taking part in clinical research. The timeliness of this money – which is out-of-pocket expenses from the study that they otherwise would not have spent – can make or break their ability to continue their participation. The goal should be to not put the patient in a worse situation than they were before they started the clinical trial – even temporarily. Just as sites don’t want the money that is owed to them by sponsors to be delayed, patients take a similar position.  

[Related article: Top 5 Subject Payment Practices to Avoid in 2017]

A better approach to reimbursements: help patients and your organization

Timely reimbursement not only increases patient satisfaction, but it also benefits those who pay patients. Through the use of modern technologies, such as Nimblify Participant Payments, research organizations can create win-wins for their clinical trials.

Improve patient retention

Each patient can choose their favorite type of several payment methods. This ensures all patients are compensated with a method they are comfortable with and prefer using. Included in these options are electronic methods that enable immediate transfer of funds, such as reloadable debit cards and direct deposit, a favorite of many patients. Additionally, each patient can use a complementary web portal or mobile app to view funds and manage notification preferences to receive an alert each time a payment has been made or reloaded.

Ensure proper visibility for all

A payment system allows you to designate roles for each user. This includes those who shouldn’t have access to PHI, such as users who need to review payment requests without seeing participants’ names to ensure blinded identities. Having control over protocol access and payment approvals help ensure information is only seen and managed by the appropriate people. Additionally, an audit trail shows who submitted each payment and users who made edits or changes, all with time stamps.

Prevent mistakes for easy tracking

With system validations and built-in logic, research organizations can rely on better safety rails for entering mileage reimbursements and provide coordinator feedback in the moment. This is all done in real-time to prevent data entry errors and ensure financial accuracy. Built-in reports also help track payment amounts across subjects and protocols while meeting financial and tax reporting needs.

Pre-set maximums

Maximums for hotel and parking expenses can be set ahead of time. Coordinators can enter requests and add comments for each type of reimbursement (parking, hotel, mileage, etc.), and if an amount exceeds the maximum, a warning message will display. Finance can then easily view a working “to do” list that auto-populates new requests to review.

In-app mileage calculations

By configuring a per-mile rate for a protocol ahead of time, coordinators can simply enter the number of miles a participant traveled and the system will calculate the reimbursement amount for them. Similarly, minimum and/or maximum thresholds for mileage reimbursement can be set ahead of time, which can be used to help identify if a participant qualifies for reimbursement based on the number of miles they live in relation to the study site.

Upload receipts on the spot

The ability to add and manage receipt attachments for participant reimbursements in the system can help both coordinators and finance stay organized and reconcile payments quickly. Uploading the receipt – in any image format – reduces the time spent processing payments while ensuring it matches the request at hand.  

The way reimbursements to participants have traditionally been handled is inefficient and takes too long. Using a payment system can drastically speed up timelines to ultimately make research participation more feasible for ALL patients.

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