POC testing

Buprenorphine Post
entjwb
Posts: 180

Postby entjwb » Mon Mar 31, 2014 10:21 pm

For Ohio physicians if you see CareSource patients, they may be contracting with only 2 labs for toxicology.

entjwb
Posts: 180

Postby entjwb » Mon Mar 31, 2014 10:21 pm

We buy our cups from a vendor through the lab. Can the lab negotiate a price for their customers based on the normal volume rate? To me this is no different than an HMO negotiating with a pharmaceutical company for a better price and making it a preferred drug with less copayment.

MChaplin
Posts: 183

Postby MChaplin » Mon Mar 31, 2014 10:21 pm

just to clarify- the "legality" issue is not referencing a company on line- the issue is the kickback issue- you must pay for the POC cups as they are considered to have "significant" worth- so if you get them from a company for free and then send your specimens to that company for confirmation, that is considered participating in a kickback and is illegal. The company can supply you with collection cups because they are so inexpensive that they are considered a convenience and not a "gift". ALSO be aware that two positive POC tests is NOT the same as a confirmation test from the lab- POC tests whether cups or dips are immuno-driven (can't use the word a$$ay without being moderated!) and have small but significant error rates due mostly to cross reactivity or in the case of klonopin, lack of cross reactivity- confirmation tests are chromotography and very rarely wrong- your lab can give you the figures but generally less than 1% error.

catschollmd
Posts: 16

Postby catschollmd » Mon Mar 31, 2014 10:21 pm

We have used a variety of immunodiffusion dip cassettes and cups.( tho many have temp built in, etc we use a forehead thermo to check if need to the temp- and standard Urine dip 10 strips to check for SG, PH, etc to****ure is urine IF in question.. Problem we have encountered is these are all made to be very sensitive (obviousely different levels if use morp and opi) but bottom line is that IF they are very sensitive they cannot be very selective so we will get some false positives. cost of retesting can be a problem with other companies and a burden to the patient and to us ,so we are now trying AMERITOX (570-589-9339) They have a nice system. We buy the standard dip cassettes (11 or 13) for whatever venders and dip in office at time of visit. If we have a concern including wanting a norbuprenorphine, we transfer turine to their container, that this companie's supplied,, label including pt insurance and fed ex out in their mailers. Then they retest and have results in 3 days., including interferring substance. And they bill insurance directly including MC and MA as well as commercial so we are not involved. IF a pt is self pay, they have a 5 question form for pt and adjust the bill to the patient as either full ($250.; 1/2 ($150.) ;or if pt poor they do it for free. this seems ok so far.

NoDrugs4u
Posts: 198

Postby NoDrugs4u » Mon Mar 31, 2014 10:21 pm

Found the Transmed cups at "www.transmedco.com" (go figure?). The 12-test cups at cliawaived.com are still the best deal I have found at about $5.68 per cup.

peterorrin
Posts: 267

Postby peterorrin » Mon Mar 31, 2014 10:21 pm

Millenium does my confirmatory testing. I discharged one patient on the spot for sequential (1 mo apart) specimens that were bup + and norbup -.

PR

MChaplin
Posts: 183

Postby MChaplin » Mon Mar 31, 2014 10:21 pm

you don't have to decant the pee- most labs will run the test on the urine from the poc cup. and as fas as i know there is no poc test for norbup. so if you don't check, there is a good chance you are being scammed by at least one person- or you will be- i agree with progress not perfection but i still think we have a responsibility to look for norbup- it is so easy to be duped. maybe at least check your "high" dose folks if you have any as they are most likely to be skimming or selling...

edibill
Posts: 101

Postby edibill » Mon Mar 31, 2014 10:21 pm

Hey NoDrugs,
The two best deals don't show up as online choices. You have to call they guy. Its painless. Easy reorder also.

NoDrugs4u
Posts: 198

Postby NoDrugs4u » Mon Mar 31, 2014 10:21 pm

Thanks edibill, MChaplin, I hope referencing vendors is not a violation because it is a big help for us newbies. I traced that number to a website with the supplies you mention (I like ordering things online). I have lab services in my office (Labcorp) for general practice and have an abundance of plain urine collection cups, they always send way more than we need. I like the idea of telling the bup patients that you will randomly send their POC UDS to the lab for confirmation, but they don't know which time you will do that. I guess there is not a POC test for norbup yet?

Signed - NoDrugs4u
I am new to this, please be gentle with me...

edibill
Posts: 101

Postby edibill » Mon Mar 31, 2014 10:21 pm

Hey NoDrugs,
(I wish we could contact each other by PM. Is referencing vendors a rule violation?)

1-800-992-1345. Ask for Mark. There are 10-12 panel cups that can be had for less than 5 bucks, shipping included. Some less that 4 if you want to just use a 7 panel that includes BUP. Call the lab that you're going to use for confirmations and they'll send you some collection cups with two little bottles, forms and shipping supplies for free. Pour the pee over into the little bottles when you need to send a sample in for testing. I don't send many specimens in for confirmation. Usually a little non-judgmental caring conversation will clear up most positives. Shoot for progress, not perfection.


Return to “Clinical Use of Buprenorphine”

Who is online

Users browsing this forum: ThomasCosse and 1 guest