Mid America Clinical Laboratories

MACL is always listening to the voice of our customers to determine areas where we exceed client expectations and where we have room for improvement. Over the past few weeks, we have felt that our outpatient STAT testing procedures have not been clearly communicated to our clients. That has left some clients with feelings of dissatisfaction, and our goal is to remedy this as quickly as possible.

What tests may be ordered STAT?

STAT testing menus vary somewhat depending upon the location where your patient presents for a blood draw. If you are in need of a STAT testing list for the site your patients utilize most often, please call our Customer Response Center or contact your sales representative for a list.

What is the Turn Around Time for STAT results?

Turn Around Time begins when the specimen arrives in the testing laboratory. It does not begin from the time the order is written or the time the specimen is drawn by phlebotomy. Typically, you could expect to receive a result in less than 2 hours. However, the laboratory metric by which we hold ourselves accountable is less than 4 hours.

How long after the result is finished will I be notified?

When the laboratory signs out a result as final, it crosses over in our computer system to the STAT call log in our Customer Response Center. Typically, you will not receive results directly from the testing laboratory, but instead, from our Customer Response associates. We will call results to you within 30 minutes of the result posting to the STAT call log.

What if my result is critical?

If the result of your STAT test is critical, it will be called to your office within 15 minutes of posting to the call log in our Customer Response Center.

Which number do you call to provide my results?

If you provide a specific telephone number on your patient’s order form, results will be called to that telephone number. If a number is NOT provided on the patient’s order form, our Customer Response Center will telephone your main office number that is associated with your MACL account number.

What happens if my office is closed when you call with results?

If there was NOT a secondary number or a directive to page with results written on the patient’s order form, we will NOT page the physician on call with STAT results UNLESS they are critical. The result will be faxed to your office.

If you desire for STAT results to be phoned to you regardless of whether your office is open or closed, that must be indicated on each patient’s order form.

Is there something specific I should write on the order form to be called after hours?

Either of the following should be sufficient. “ Page MD on call with results” or “Call results to (insert phone number).”

Should patients be hospital registered for STAT testing?

In order to expedite STAT testing and receive your patient’s test results through MACL’s reporting systems, it is recommended that they be instructed to go directly to the laboratory for specimen collection without stopping at hospital registration. Exception: St Vincent Hospital Laboratory 86^th is unable to accept STAT patients directly.

Is there other information that should be included on the patient’s order?

Please remember to clearly indicate that you are requesting the testing STAT. Be sure to write STAT in large, clear letters on the order to ensure it is not overlooked. If you are including a specific telephone number or instructions, be sure they are clear and easy to read.

We hope reviewing our current procedures with you regarding STAT testing will ensure that each patient receives the best possible care in the timeliest fashion. Our goal is always put the patient first in everything that we do.

Mid America Clinical Laboratories is now offering discount laboratory fees for self-pay patients at some of our Patient Care Centers (PCCs). As part of this offering, we have implemented a full payment at time of service policy.

We will accept personal checks, Money Orders, Visa, MasterCard or American Express. For the safety of everyone, cash will not be accepted.

Please note that, although the policy is to require payment from uninsured patients PRIOR to collecting specimens, our intent is never to compromise patient care in the process. Extraordinary circumstances will always be considered.

The PCC locations listed below will be implementing the new policy by the end of March. The policy will be implemented at all PCC locations by the end of 2010.

Marion 1001 North Western, Suite B,

Marion, IN 46952

Clearvista North 8436 Clearvista Place,

Indianapolis, IN 46256

Muncie 100 North Tillotson,

Muncie, IN 47304

Crawfordsville 1702 Lafayette Road,

Crawfordsville, IN 47933

Olio Road 13121 Olio Road, Suite 130,

Fishers, IN 46037

Connersville 1475 State Road 44 East,

Connersville, IN 47331

Terre Haute 4797 South 7^th Street,

Terre Haute, IN 47802

Signs have been posted in the PCC locations to alert patients of the upcoming change.

Patients who are uninsured may visit the MACL website (www.maclonline.com) and view a list of 150 of the most commonly ordered tests and their price.

We would appreciate your assistance in communicating this policy to patients referred to our PCC locations. As always, thank you for choosing MACL as your laboratory partner.

Test Code 5059 Maternal Serum Screen 1(AFP)

7292 Maternal Serum Screen 3 (triple)

30294 Maternal Serum Screen 4 (Quad

Screen)

16020 Maternal Serum Screen, 1^st

trimester.

Effective March 8, 2010, there will be a change in question verbiage when ordering any Maternal Serum Screening (MSS) in both electronic and paper formats. The order entry question and/or requisition listed question “Donor age or date of birth” will be changed. The new verbiage will be: “Donor Age: Egg Retrieval” to clarify that we need the age of the egg donor at the time the egg was harvested. If the answer is no, it continues with other questions. If the answer is yes, it will require the age of the donor at the time the egg was harvested.

This will affect the following tests:

Maternal Serum Screen 1(AFP)

Maternal Serum Screen 3 (triple)

Maternal Serum Screen 4 (Quad Screen)

Maternal Serum Screen, 1^st trimester.

This change will appear in your Care360 on March 8, 2010. New paper OB/GYN and AFP requisitions ordered after this date will indicate the new verbiage. Stickers will be provided to physicians indicating “Donor Age: Egg retrieval” for their current OB/GYN and AFP paper requisitions. If you have not been provided these stickers, please contact your sales representative or contact customer service at 803-1010.

Since we have started a new year, we want to remind our clients of our credit policy. We hope this explanation will clarify our policy.

The information below focuses only on credits requested by a physician office or patient for an error made at the physician office. Traditionally, the office accidentally orders an incorrect test or indicates the incorrect bill type. An example might be that the requisition indicated to bill the insurance, but at a later date, the client realizes they had meant to indicate bill client.

Compliance regulations around requisition billing can be confusing. The first rule of thumb is that all tests ordered on a single requisition must all be billed the same way. For example, your office orders four tests. All four must be billed to insurance or client or patient. They cannot be split-billed, and an example of that would be three billed to insurance and one billed to client.

The second regulation surrounds changes to requisitions originally billed to insurance. Claims are sent to the insurance company within 24 hours of the test being reported. If a claim has been submitted to the insurance company, it cannot be transferred from insurance to client bill or patient bill. However, if the requisition was originally billed to client or patient, we have the ability to transfer the claim to the patient’s insurance.

If your office makes an ordering error, MACL will consider a forgiveness credit. Currently, our policy is to allow each client to request 2 forgiveness credits per year for physician office errors. These forgiveness credits may be for tests billed to a patient’s insurance, to your client bill or to the patient directly.

We do know these regulations may be frustrating for your office. However, MACL is required to adhere to compliance regulations surrounding credit requests.

Dunn Memorial Hospital

Mid America Clinical Laboratories continues to work closely with local hospitals to provide the highest quality laboratory services. The most recent hospital to join MACL is Dunn Memorial Hospital located in Bedford. The city’s first hospital opened its doors in 1904. Through continuous renovations and state-of-the-art technology, Dunn has been providing Bedford residents with exceptional care for over 100 years. The hospital currently employs over 400 Hoosiers and has maintained its status as a staple in the community.

Welcome!

NEW PATIENT CARE CENTER OPENING ON COUNTY LINE ROAD

MACL is pleased to announce the March 15, 2010 opening of a new Patient Care Center on County Line Road.

County Line Medical Pavilion

333 East County Line Road, Suite C

Greenwood, IN 46143

Hours: Monday through Friday,

7:00 a.m. -4:00 p.m.

Saturday, 7:00 a.m.-12:00 noon.

SENDING SPECIMENS DIRECTLY TO A REFERENCE LABORATORY

Please be sure to fax a copy of the reference lab requisition (including Clarian) to the Referral Department at 803-0093 any time you send a specimen directly to a reference laboratory.

WEBSITE ENHANCMENTS

Patients who are uninsured may now visit the MACL website (www.maclonline.com) and view a list of 150 of the most commonly ordered tests and their price. Select “Patient Tools” on the menu bar and choose IndyTestResults.com from the drop-down menu. Scroll to the bottom of the page and select Commonly Ordered Patient Discount Fees (link to PDF of fee schedule). This will take you to the test list and the uninsured patient price.

The Regional Laboratory for Mid America Clinical laboratories (MACL) is located on North Shadeland Avenue just north of I-70 in Indianapolis. MACL is a high tech laboratory offering a full menu of laboratory testing including many esoteric and high complexity testing options to meet the needs of our clients. Ninety five percent of the testing you order is completed in our Regional laboratory. We are very proud of our facility and invite you to contact your sales representative to schedule a tour of the laboratory.

Our 75,000 square foot facility showcases our OLA (Olympus Laboratory Automation). This automated front end processing system is unique to MACL, as it is the only one in the state of Indiana. The OLA improves patient safety by eliminating human error for sample aliquoting and labeling; measuring the amount of specimen required by use of defined aliquot tube volume; and identifying sample integrity by detecting clots. The OLA improves turnaround times due to faster sorting of specimens to instruments for testing.

MACL also prides itself on having the largest Special Coagulation department in the state performing a multitude of esoteric tests daily. MACL’s Molecular Diagnostic Testing department uses the most up-to-date technology available. Both departments provide clients with cutting edge testing options to that provide information for better decision making in determining treatment options for patients.

MACL is a leading provider of clinical laboratory service in the central Indiana geography.

To schedule a personal tour, please contact your sales representative.

From the ASCCP (American Society of Colposcopy and Cervical Pathology) HPV Genotyping Clinical Update, 2009:

Based on the data available in 2006, it was determined that in cytology negative women 30 years and older who are HPV DNA positive (for any of the 13 or 14 high-risk types of HPV detected by the high-risk HPV assays) molecular genotyping assays that detect HPV 16 and 18 would be clinically useful for determining which women should be referred for immediate colposcopy, and which could be followed-up with repeat cytology and high-risk HPV testing in 12 months.*

Mid America Clinical Laboratories is pleased to offer HPV types 16 and 18 genotyping to our clients. A variety of ordering options are available.

1. Test Code 19863 HPV, High Risk DNA, Hybrid Capture II, w/Reflex to HPV 16/18 genotyping

2. Test Code 70015 Pap, Liquid Based AND HPV, High Risk DNA, Hybrid Capture II, w/Reflex to HPV 16/18 genotyping

3. Test Code 51363 Pap, Liquid Based w/Reflex to HPV, High Risk DNA, Hybrid Capture II, w/Reflex to HPV 16/18 genotyping

4. Test Code 51364 IMG Asst Pap AND HPV, High Risk DNA, Hybrid Capture II, w/Reflex to HPV 16/18 genotyping

5. Test Code 51365 IMG Asst Pap w/reflex to HPV, High Risk DNA, Hybrid Capture II, w/Reflex to HPV 16/18 genotyping

* The ASCCP HPV Genotyping Clinical Update, 2009 can be accessed in its entirety at:

http://www.asccp.org/pdfs/consensus/clinical_update_20090408.pdf

Mid America Clinical Laboratories will be changing the components of our stool culture to include testing to detect the presence of Shiga Toxin producing E. coli (STEC). The purpose of this initiative is to comply with strong recommendations from the Centers for Disease Control (CDC) that all laboratories routinely screen patients for infection by STEC as part of “routine” stool culture procedures. In two separate editions of Morbidity and Mortality Weekly Report (MMWR), the CDC has called for routine testing for these bacteria, when a clinician orders a “Stool Culture”.

The CDC is also requesting that E. coli O157 culture be performed on patients with positive toxin assays for the purpose of submitting the isolate via a public health laboratory to the CDC’s “Pulse Net” program which is designed to track outbreaks of food borne illness.

Therefore, effective June 7, 2010, order code 10045, Stool Culture (Salmonella, Shigella, Campylobacter only) will no longer be available. Order code 10045 will be replaced with order code 10108, Stool Culture (Salmonella, Shigella, Campylobacter and Shiga Toxin EIA with reflex to E. coli O157 culture) as our comprehensive “Stool Culture”. Orders for test 10045 placed after June 7, 2010 will be pointed to test code 10108.

Mid America Clinical Laboratories will be transitioning to a single, universal viral transport medium that will maintain the viability of Viruses, Chlamydiae, Mycoplasmas and Ureaplasmas. The green-top tube contains 3.0 ml of V-C-M (Viral-Chlamydia-Mycoplasma) medium and can be stored at room temperature prior to use. The single tube will streamline collection by replacing both the blue-top M4 and red-top M4RT transport media currently in use. Refer to the MACL Directory of Service for detailed instructions on storage and transport of specimens following collection.

Current Transport

Test Name Order Code

New transport

Blue-top M4 transport medium

· Culture, M. hominis and

Ureaplasma

871

Green top

V-C-M transport medium*

Red-top M4RT transport medium

· Culture, Herpes Simplex Virus Rapid

· Culture, Herpes Simplex Virus with typing

· Herpes Simplex Virus/Varicella Zoster Virus, Rapid Culture

· Culture, Viral Body Fluids

· Influenza A & B antigen detection

· RSV Antigen Detection

· Chlamydia trachomatis culture

2692

2649

17495

689

51029

51293

690

*V-C-M will most frequently be available in a green top tube; however, if the supply must be obtained through an alternate distributor, the medium may also be available in other colors and labeled as Universal Transport Medium for Viruses, Chlamydiae, Mycoplasmas and Ureaplasmas.

Mid America Clinical Laboratories is now offering discount laboratory fees for self-pay patients at some of our Patient Care Centers (PCCs). As part of this offering, we have implemented a full payment at time of service policy.

We will accept personal checks, Money Orders, Visa, MasterCard or American Express. For the safety of everyone, cash will not be accepted.

Please note that, although the policy is to require payment from uninsured patients PRIOR to collecting specimens, our intent is never to compromise patient care in the process. Extraordinary circumstances will always be considered.

The PCC locations listed below have now implemented the new policy.

Lafayette 1345 Unity Place, Suite 125,

Lafayette, IN 47905

10^th Street 10122 East 10^th St., Suite 200,

Indianapolis, IN 46229

Eagle Highlands 3850 Shore Drive, Suite 101,

Indianapolis, IN 46254

Greenfield 740 W. Green Meadows Drive,

Greenfield, IN 46140

Castleton 8202 Clearvista Pkwy, Ste .10C,

Indianapolis, IN 46256

Southpointe 8936 Southpointe Drive,

Indianapolis, IN 46227

Greenwood Pavilion 333 E. County Line Road,

Greenwood, IN 46142

Richmond 816 Dillon Drive,

Richmond, IN 47374

Connersville 1475 State Road 44 East,

Connersville, IN 47331

Clearvista 8040 Clearvista Dr., Suite 110,

Indianapolis, IN 46256

Carmel 13450 N. Meridian St., Suite 356,

Carmel, IN 46032

Pembrooke 1950 W. 86^th St., Suite 101,

Indianapolis, IN 46260

Harcourt 8301 Harcourt Rd., #139,

Indianapolis, IN 46260

Naab Road 8240 Naab Road, Suite 150,

Indianapolis, IN 46260

Heather Glenn 8424 Naab Road, Suite 1C,

Indianapolis, IN 46260

16^th Street 5317 E. 16^th Stree, Suite 1,

Indianapolis, IN 46218

Caito Drive 5660 Caito Dr., Ste. 124, Bld. 3,

Indianapolis, IN 46226

Waterpark Place 9011 N. Meridian St., Suite 204,

Indianapolis, IN 46260

Fishers 13050 Parkside Drive, Suite 130,

Fishers, IN 46038

MedCheck 11911 N. Meridian St., Suite 165,

Carmel, IN 46032

Terre Haute 4797 S. 7^th Street,

Terre Haute, IN 47802

Muncie 100 N. Tollotson,

Muncie, IN 47304

Marion 1001 North Western, Suite B,

Marion, IN 46952

Clearvista North 8436 Clearvista Place,

Indianapolis, IN 46256

Crawfordsville 1702 Lafayette Road,

Crawfordsville, IN 47933

Olio 13121 Olio Road, Suite 130,

Fishers, IN 46037

Signs have been posted in the PCC locations to alert patients of this change.

Patients who are uninsured may visit the MACL website (www.maclonline.com) and view a list of 150 of the most commonly ordered tests and their price.

We would appreciate your assistance in communicating this policy to patients referred to our PCC locations. As always, thank you for choosing MACL as your laboratory partner.

CPI/Clearvista Women’s Care

CPI/Clearvista Women’s Care is an OB/Gyn practice located at 7120 Clearvista Drive, Suite 400, in Indianapolis. Practitioners include: Kristina Box, Mary Beckwith, Kathleen Bemenderfer, Pratima Stuhldreher, John Wagner, Sonja Voelkel, Shawn Bourke, Chemen Tate, Allison Pickett and Cathy Hansell. The practice was formed 20 years ago and currently has 40 employees. Clearvista Women’s Care is a very family-oriented practice with a large referral base within a family/friend network. The doctors within this practice cover calls for each other. This allows their patients to be familiar with the entire group. They perform any procedure possible in the office to make the patient feel more comfortable. Clearvista Women’s Care offers an obstetrics program, obstetrics education and classes. They teach up to 15 classes a month at their location.

Welcome!

* * * * * * * * * * * * * * * * * * * * * * *

Southside Family Medical Group

Southside Family Medical Group was founded in 2001 and has grown to a practice of four physicians and over 20 associates. Practitioners include: Rhonda Goul, Eric Wallisa, David Williams, and Mary Yoder. Southside Family Medical Group provides continuing and comprehensive patient care and delivers excellence in family medicine through innovative practice-based health services through their state-of-the-art facility. They specialize in comprehensive medical care for patients of all ages and serving the medical needs of one’s entire family.

Welcome!

NEW PATIENT CARE CENTER

Lafayette Patient Care Center

2606 East County Road 350 South

Building B, Unit 1

Lafayette, IN 47909

Hours: Monday, Tuesday, Friday, Saturday --

7:00 a.m. - 12:00 noon

* * * * * * * * * * * * * * * * * * *

NEW PATIENT CARE CENTER HOURS

New Saturday Hours

Saxony Olio Pavilion Patient Care Center

13121 Olio Road, Suite 130

Fishers, IN 46037

Hours: Monday-Friday - 7:30 a.m. - 12:30 p.m.,

1:30 - 4:30 p.m.

Saturday -- 7:00 a.m. - 12:00 noon

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