As the current environment in health care with the abuse of prescription medications combined with the CDC’s classification of pain medication abuse as an “epidemic,” there is a movement towards requiring the use of toxicology testing for every patient prescribed any mood or mind altering pharmaceutical. Many states are now requiring you to check in with a database to ensure your patients are not “shopping” for pain medications and many of you have heard recent news of the growing number of cases of physicians being held accountable and/or patients being investigated for abuse of their prescription medications.
Combine this abuse of prescription medication with the recent court cases involving Medicare reimbursement and/or fraud involving toxicology confirmation testing, and it is easy to see we are in the middle of a tumultuous period as far as how to proceed with patient care while protecting yourself as a physician and complying with oversight.
So, the real question is not, “Why do I need it?” but really, you should be asking yourself who offers a trusted solution that provides protection for you and your clinic while helping you put your patients and their care first?
Our toxicology solutions, ranging from urine dipstick cups to immunoassay analyzers to tandem mass spec confirmation testing, offer the best-in-class solution that not only fits your needs, but works hard to comply with all regulations to ensure that smooth operation is maintained and that neither you nor our company will be subjected to investigations involving any form of abuse or any other problems that might cause oversight committees to come down on us. We want to comply with all regulations and we work hard to maintain our partnerships with our clients.
By offering customized testing that allows only confirmation testing to be performed when necessary as well as investigation into specific drug classes, we help to ensure that we are compliant and maintain all regulations set forth.
How much time will it take to do?
This just depends on your specific situation and requirements. As we offer a full range of toxicology testing services, implementation can take as little as a couple of days or it could take a couple of months. Helping a clinic get started with basic urine dipstick cup point-of-service testing requires a little education on use and analysis, usually requiring a few days, while implementation of an immunoassay analyzer for in-clinic testing could take as long as 90 days depending on your current set-up in your clinic.
We help with implementation of testing from the ground up, no matter what level you are interested in and is applicable for your practice. We help with staffing, instrumentation, accreditation, validation; basically, we are able to help with every step along the way.
Whether your clinic is able to institute your own mass spectrometer for confirmation testing or you utilize our services, we will work with you to help determine your need and help you implement everything.
How much will it cost?
This is specific to the requirements you have. If you are instituting point-of-service urine dipstick testing and utilizing our labs for confirmation testing, the only costs involved are with purchasing of urine dipstick cups, we take care of everything else.
Should you have the capabilities and need for an immunoassay analyzer, or even a mass spectrometer, we will help you find financing if needed, help you obtain all of your accreditations, help you find your staff. We will make sure it is a viable option before we proceed and we will discuss options with you. Cost is dependent upon your unique situation but all expenses will illustrated and discussed with you.
How much revenue can I expect to make?
This is dependent upon sample load as well as your configuration and testing abilities. Also, medical necessity must be factored in. Toxicology testing can be very lucrative but it must be done properly.
To discuss real world numbers, dependent upon your situation, please contact us directly so we can learn more about your specific situation and discuss options with you.
Who pays for this service? (Payer types)
All forms of insurance reimburse for toxicology testing. Reimbursement rates are very dependent upon insurance provider.
Unless your clinic is part owner in the confirmation lab, there is no legal way you can generate revenue off of toxicology confirmation testing. Our Co-op lab model, as well as our ability to address your specific situation, guarantees that you will receive the highest return for your investment and that you will maintain operation within all legal restrictions.
What type of patient needs this?
Any patient being prescribed any mind or mood altering prescription including, but not limited to, pain medication, ADHD medications, anti-depressants, anti-anxiety medications, etc.
What type of practice is this best suited to?
Really any practice prescribing the aforementioned medications.
What do I need to do to get started?
Contact us so that we can begin the process of working directly with you to understand your practice and your needs. We will then begin customizing our solution for you and explaining the options available to you.
How long will it take to get implemented?
From days to months, very dependent upon your specific scenario.
What makes this solution different to other providers of this type of product?
We focus on our partnership with you and we have developed a customizable solution that offers all forms of toxicology testing and can assist the implementation of our solution into your practice from the ground up. We maintain a constant watch over
Is it legal/STARK compliant/anti kick back?
In the toxicology testing arena, this is one of the key areas that clinics and confirmation testing services need to be aware of. STARK and other regulations, help regulate testing services and can be very strict. Our services focus on maintaining compliance. We want to uphold a long term partnership with our clients so we keep an eye out for changes in legislation, key legal decisions being made, and keep abreast of all changes in order to maintain compliance in order to protect our partners as well as ourselves.
Our solutions do maintain compliance and we offer the highest legal return of investment possible.
What do I tell my patients?
This can be a touchy subject because, as health care providers, you are putting patient care and well-being above all else. Testing, specifically toxicology testing, isn’t medically necessary in the sense that you need it performed to help improve a patient and their outcome, but it is quickly being mandated across the nation.
So, the argument is not whether to test but how to address testing with your patients. Through the suggestion of the CDC and other governing bodies, toxicology testing is becoming mandatory. Therefore, if you prescribe a medication that requires testing, you should be testing your patients.
Abuse of the system comes in when confirmation testing is being performed on every patient for every class of drugs. This generates large bills for insurance and has caused increase scrutiny over the past few years.
As part of your plan of action, when treating a patient for pain, attention deficit, anxiety/stress, depression, as well as other problems, testing should be included and you should explain to your patients that it is being required in order to prescribe certain medications. Should a patient no longer want treatment because they are being subjected to testing, they dissolve the relationship with between them and you as a healthcare provider and absolve you of their care and possible abuse of medications. In a sense, you are protecting your patients as well as yourselves by testing.
How does it benefit my practice?
It complies with new regulations as well as suggestions made by the CDC. It does generate revenue but, as discussed previously, this should not be the deciding factor on whether or not to test your patients. It helps to improve patient outcome by generating patient responsibility in their own care and it helps protect you, your practice, as well as the patient.
What space/staffing do I need?
Dependent on specific situation. As little as no extra space or as high as floor space required for instrumentation.
What codes do I use?
Dependent upon situation and usually not applicable unless you are referring to point-of-service urine dipstick testing only. All other CPT codes are utilized by the lab. Your specific situation will be discussed with you and all codes will be discussed at that time.
What if I don’t do this?
You could find yourself in violation of new regulations and could have investigations opened into your prescribing practices and, possibly, patient prescription abuse. Implementing testing provides protection, keeps you compliant, and helps to ensure patient responsibility and improve patient outcome.