** Patient Support Services Department: 301-496-2341, Mon-Fri 6:30am-4:30pm**
Funeral Services Form - FAQs & Guidelines
Funeral Home Services Request Form (Non-Indigent)
Medical Administrative Series M08-1: Reimbursement of Travel and Subsistence Expenses for NIH Clinical Research Protocol Participants
Non-Urgent Ambulance Requests
- From an outside medical facility to the Clinical Center
- Usually the hospital where the patient is located makes the arrangements but CC Admissions can make the arrangements
- Notify Admissions of any transfers by ambulance so they can inform the NIH Police Emergency Command Center (ECC) so the ambulance is not held up in a security line
- Complete this form
- The CC has 2 taxi contracts: Barwood and Regency
- The majority of requests are submitted by phone; some ICs provide a typed list of requests to the Transportation Desk staff.
- Requestors must provide traveler(s) name, pick-up and drop-off destination, date/time, CAN to be charged or protocol #, requestor name and phone number. Patient cell phone is helpful especially if patient is coming from an airport.
- The taxi company cannot be called with an estimated time. If the IC person authorizing the trip doesn’t know the exact time the patient will need the taxi, an estimated time can be provided, but someone has to call with the exact time before the taxi company will be notified.
- Karen Kaczorowski is the Contract Officer Representative (COR) for taxi companies and should receive any complaints regarding the service provided.
- The NIH Transportation Desk: 301-496-1161
- Mon-Fri 7am-7pm, Sunday 9am-5pm
- Calls automatically transfer to Admissions when the Transportation Desk is closed
Air/Train Travel Arrangements
- Requests for Air/Train Government-Arranged Travel (GAT) are submitted via the ATV system
- Tickets are fully refundable to the government if the trip is changed or cancelled
- Round trips should be submitted, even if the return date is not known. If a one-way, patients may be held up in security.
- After hours, Admissions can make changes to tickets if authorized. Most of these are requests to change existing tickets. If there is a question about authorization for a trip, the Admissions staff person will contact a supervisor.
- The MAS on travel (attached) covers authorized travel between home of record and NIH CC. Any deviations from this will require a travel exception from Caryn Steakley or Bill Dahut.
- Omega (a HHS contract) arranges for the least costly travel so the trip destination can be with Reagan, BWI or Dulles. Different destinations will require an exception from Caryn Steakley or Bill Dahut.
- International patients are covered from U.S. port of entry. Any travel directly from their home requires an exception from Caryn Steakley or Bill Dahut.
- Omega On-Site Patient Travel Office
- 301-496-6676, 1-866-227-9339, Mon-Fri 8-6pm
- Calls automatically transfer to Admissions when the Omega is closed
In House Expirations
- The research team and social worker will determine if any services will be paid from either 1. Indigent burial contract or 2. By the Institute
- Indigent burial contract: social work completes the form of what is being covered and paid for from CC funds and will submit to Admissions
- Non-indigent burial contract (see attached): IC will determine if they will pay for any services. Request form will be completed and submitted to Admissions.
- Admissions will be responsible for coordinating everything, including assisting the physician with the death certificate, having the next of kin complete the disposition of body form and any other needed documentation, and coordinate the services with the contract burial contractor.
- Payment for services
- If IC is paying, the PSSD staff person will enter the request into POTS, prior to the services performed and will process the invoice once received from the funeral company. The invoice will be reviewed and approved by Karen Kaczorowski/designee and sent to the CC Procurement for payment.
Bodies/Body Parts Brought to the CC for Autopsy
- Social Work is NOT involved in this process
- Contact PSSD or Admissions
- When an IC knows that they will want a body transported after death to the CC for autopsy the following must be done:
- Notify Admissions about pending expiration
- Name of patient, location, name of next of kin and contact info
- IC contact name and number
- Urgency for when autopsy has to be done after death
- IC has to notify NCI Anatomical Pathology, in advance, of their intent for autopsy
- An Outside Medical Services form (2541) is required to indicate what services will be paid for by the institute
- Admissions will coordinate everything with the IC rep, family and contract funeral home
- Payment for services
- If IC is paying, PSSD staff person will enter the request into POTS, prior to the services performed and will process the invoice once received from the funeral company. The invoice will be reviewed and approved by Karen Kaczorowski/designee and sent to the CC Procurement for payment.
- The IC usually arranges for the shipment of body parts in consultation with NCI Anatomical Pathology
- Admissions has to be informed of the arrangements and expected arrival so they can accept the body part, in the morgue and notify Anatomical Pathology.
**ALL services that require payment need to have approval before the services are performed otherwise it is an Unauthorized Procurement and will likely not be paid. To avoid this, use a Form 2541-Request for Outside Medical Services, have it signed by either Caryn Steakley or Bill Dahut, then submit it to the appropriate persons.