Insurance Collections – specific instructions

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APPENDIX A – INSURANCE COLLECTION

Note:  Eight (8) hour fast is recommended prior to blood collection.

1)      The following must be filled out on the requisition form found in the collection kit.

¨      insurance company name

¨      type of insurance (take from exam order)

¨      agency name taken from exam slip (if not available, leave blank)

¨      agent name / number

¨      applicant name (verify correct spelling of name with applicant)

¨      applicant date of birth

¨      social security number  (optional-per carrier instructions)

¨      gender

¨      applicant’s driver’s license number

¨      picture verified

¨      applicant address, city and state are essential

¨      last food and drink (date and time)

¨      date and time specimen was obtained

¨      urine temperature

¨      smoking questions must be answered

¨      exam company name, city, state and phone number

¨      applicant’s signature and date

¨      examiner’s name and examiner’s signature and date

2)      The applicant must read and sign the authorization slip before conducting the blood draw (see Blood Collection procedure). Do not draw blood specimen if applicant declines to sign or alter the slip.

3)      Confirm the identity of the applicant by checking at least two identifiers before collecting the specimen(s). This can be done by asking the applicant to state their full name and requesting to see the patient’s driver’s license to verify picture, name, date of birth and/or drivers license number and documenting the information on the consent/chain of custody form.

4)      VERY IMPORTANT – Make sure that no blood drawing equipment is left at the applicant’s home or place of business.  Discard needle and gloves in approved biohazard containers.

5)      A urine sample is required to be sent with all blood profile kits.

6)      Have applicant collect urine sample in cup provide (see Urine Collection procedure).

7)      Record temperature of urine on requisition slip.

8)      Pour urine into appropriately labeled urine pour-off tubes.

9)      Tamper-evident tape must have: applicant’s signature and date. Affix tape to tube that does not have a barcode label.

10)  If applicant is unable to void, arrange for a second appointment for the entire kit.

11)  After following all specimen handling procedures, repackage the blood kit. Make sure all tubes are placed in the proper position for packing and ship kit to lab via overnight courier service or other shipping service (e.g. U.S. Postal Service) as directed. Specimens should be shipped within 24 hours, or on the next available shipping day. If the specimen collection cannot be shipped on the day of the collection, refrigerate until the specimen collection is shipped.

12)  Send one (1) copy of the authorization slip to the lab with the kit and return remaining copies to the paramed office.  Leave one (1) copy with the client.

13)  Notify local paramed Manager immediately if any problems of any kind occur.