Then the finance office calls.

The sponsor has paid for six of the 11 enrolled participants. The invoices for the other five were never submitted--or were submitted and rejected for missing documentation. The three screen failures? Zero reimbursement. The contract includes a screen failure fee of $375 per failed participant, but nobody submitted those invoices either. That is $1,125 in screen failure revenue sitting uncollected, and five participants' worth of per-visit payments--tens of thousands of dollars--stuck somewhere between "work completed" and "payment received."

The coordinator did the work. The site spent the money. But the financial trail between completed procedures and received payments had gaps that nobody was watching.

This is not a story about negligence. It is a story about a gap in responsibility that exists at most clinical trial sites. The business office knows how to submit invoices but does not know which participants completed which visits. The coordinator knows exactly which participants completed which visits but does not track whether those visits were invoiced. The investigator assumes the financial side is handled. And the site manager discovers the problem only when cash flow becomes visibly strained or--worse--when a finance audit reveals months of uncollected revenue.

Budget tracking during an active study is not the coordinator's primary responsibility. You were not hired to be an accountant. But you are the person who knows, with precision, which procedures were completed, which participants hit which milestones, and when billable events occurred. That operational knowledge is the raw material of invoicing. And if nobody is converting that knowledge into financial action, money disappears.

Then the finance office calls.

The sponsor has paid for six of the 11 enrolled participants. The invoices for the other five were never submitted--or were submitted and rejected for missing documentation. The three screen failures? Zero reimbursement. The contract includes a screen failure fee of $375 per failed participant, but nobody submitted those invoices either. That is $1,125 in screen failure revenue sitting uncollected, and five participants' worth of per-visit payments--tens of thousands of dollars--stuck somewhere between "work completed" and "payment received."

The coordinator did the work. The site spent the money. But the financial trail between completed procedures and received payments had gaps that nobody was watching.

This is not a story about negligence. It is a story about a gap in responsibility that exists at most clinical trial sites. The business office knows how to submit invoices but does not know which participants completed which visits. The coordinator knows exactly which participants completed which visits but does not track whether those visits were invoiced. The investigator assumes the financial side is handled. And the site manager discovers the problem only when cash flow becomes visibly strained or--worse--when a finance audit reveals months of uncollected revenue.

Budget tracking during an active study is not the coordinator's primary responsibility. You were not hired to be an accountant. But you are the person who knows, with precision, which procedures were completed, which participants hit which milestones, and when billable events occurred. That operational knowledge is the raw material of invoicing. And if nobody is converting that knowledge into financial action, money disappears.