Logistics
T or F
Preferred method of communication when speaking with shipping is their direct line?
NO!
C.A.P. accreditation stands for this.
College of American Pathologists
This is our out-of-network/Uninsured rate.
$125
EX: Patient has United Healthcare, $5k deductible, and it's February.
In regards to Billing...this is a huge difference between US and most niche PCR labs.
WE ARE IN-NETWORK. We have been a lab for 10+ years and formulated relationships/In-network contracts with over 400 payors nationwide
This is the process to order a pathogen positivity report.
Email Jane Chung, provide Account ID, & Date Range.
Bonus: If a provider is concerned about cost, what's an additional request to Jane for their specific practice report
These 3 pieces of information are required when requesting an on-call Carrier Pick-Up.
1) What is the specific carrier
2) What is the time window needed
3) Salesforce Account ID
DONT SEND REQUESTS FOR MULTIPLE ACCOUNTS IN SAME EMAIL
Ureaplasma (high) & Bacterial Vaginosis (moderate) are detected in our report. This is the reason why BV is not included in the personalized antibiogram.
It is considered an expected bacteria or type of normal flora. It's not included because it's not always pathogenic or recommended to treat. Only when clinically indicated.
These are the 3 options we offer patients with bills.
Prompt pay discount, payment plans, and financial hardship.
BONUS: what is our prompt pay discount?
T OR F
We have to bill out responsibility if there is a co-pay or deductible. The Doctor's office DOES NOT.
False.
Expand. Don't apologize.
This is how to explain Resistance Genes in our HTRX Report.
We identify mutations in the sample collected. Based on the presence of these genes, we understand which antibiotics may not be appropriate and we remove them from our recommendations to treat.
Expand: Where does this info come from*
The only appropriate time to NOT put an orange priority sticker on shipping bag is.
When it's just COVID-19 Samples
Copies/ml is validated to this on a Culture & Sensitivity test.
CFU's or colony forming unit.
The provider states they have high percentage of Medicaid. The provider is concerned about cost. This is a compliant response to help alleviate that concern.
We have negotiated rates with many Medicaid plans nationwide.
Regardless, whatever they pay us, we accept as payment in full. They should not receive responsibility.
There are specific CPT codes billed to insurance based off of pathogens ordered. This is what's provided by the office in order to justify those tests to a payor.
Diagnosis Codes (ICD-Codes)
expand
The majority of pathogens from our Genito/STI can be detected just by swabbing the patient's Urine. There are situations where you may want to collect an additional swab. Name 2.
There is a lesion out side of the Urinary Tract
There is visible discharge
HPV - Best collection from cervical Swab
What are others?
Let the provider make the decision
For the placard to go live with UPS the following Monday, you would of had to send in pictures by this day.
Tuesday of the previous week
Bonus: Per Mark's email, this is the cutoff time.
These are a few reasons why a specific antibiotic will not show up on a patient's Personalized Antibiogram (front page). Name two.
1) The resistance gene associated with that antibiotic is present
2) Another pathogen is present which is NOT treated with that antibiotic
BONUS: What's a third reason?
A provider is worried about cost to their patients. These are 3 things we do/offer on the FRONT END in order to help control cost.
We offer Expanded/Targeted menus EX: GCT
We have over 400 In-network contracts nationwide
We give you the option to customize menus based on medical necessity (Personalized Menus)
The provider does rapid testing for RSV, FLU, & Strep and collects reimbursement. This is why they shouldn't be concerned with utilizing our tests in addition.
We bill completely different codes with our Molecular testing VS their in-office rapids. Not a double-bill situation.
Often in Urology/Women's health, providers use a clean catch/catheter in order to identify urinary pathogens in Culture. This is why.
Culture has a hard time growing poly-microbial infections. Normal flora or common pathogens like E-Coli/BV in Urinary Tract may cause contamination if collected in a dirty catch.
BONUS: why does this NOT matter with us?
For a NEW CWP customer utilizing us for STI/UTI testing, these are the 7 supplies that should be ordered.
What is:
RPP Kits-Individual Swabs-Urine Cups-Barcode Scanner-Orange Core Stickers-Carrier Shipping bags-Carrier Shipping Labels
Gonorrhoeae and Trichomonas are considered pathogenic and recommended to treat. This is the reason why they are not in our personalized antibiogram on front page.
There are 1-2 appropriate antibiotics to treat (trichomonas) or potentially may require a combination of antibiotics to treat (Gonorrhoeae)
BONUS: How often have these Pathogens affected Kyle Rhoad's life?
This is our financial Assistance policy for FQHC's regarding their sliding fee patients.
Our financial assistance program will match & alleviate any responsibility for your sliding fee participants.
Bonus: Quest, LabCorp and Labs alike. Their poverty guideline is typically this. Ours is this.
A provider has a patient that received a High Bill (due to deductible). This is the tool that you can provide them in order to understand pathogens common to their patient population, and to help from over-ordering.
Pathogen positivity report.
Bonus: How is this utilized in order to control cost?
Culture struggles to detect pathogens for multiple reasons. Name 3 common specific pathogens difficult to culture in an Urgent Care setting. Don't USE GCT.
Ureaplasma, Mycoplasma, Enterococcus or others