A policy for documenting the referral of tests to laboratories outside the United Clinical Laboratories (UCL) system.
1. Record the following information on the “Reference Test Log”, at the time of referral:
A. Patient demographics, including:
Note: If available, a patient’s demographic label from the computer generated requisition can be placed in the space labeled “Demographics”.
a. Patient name
b. Patient ID number
B. UCL accession number
C. Date and time of specimen collection
D. Test name(s)
E. Reference lab specimen is sent to (Mayo, UHL, etc.)
F. Date sent
G. Initials of UCL employee logging referral
H. If the patient is not a hospital patient, indicate if the patient’s insurance is either Medicare and/or Title XIX by circling “Yes” or “No”.
2. When results are returned from the reference laboratory the following information is recorded on the “Reference Test Log”:
A. Date results were received at the UCL site referring the sample
B. Initials of the UCL employee receiving the result
3. When the bill is received from the reference laboratory, record the date received on the “Reference Test Log” by initialing the “Bill Rec’d” column. Verify that UCL is not billed for any Medicare or Title XIX patient as identified in II.1.H.
4. Storage Requirements:
A. Reference Test Logs are retained for 2 years
B. The UCL copy of the test results received from the reference laboratory are retained for 2 years.
i. December 1989 L. Kelley
ii. December 2002 L. Kelley (Revised: II.3. added)
July 2010 C. Leslein, S. Hosch (Revised: log & protocol)
July 2011 A. Cone (no changes)