Submitting a New Out-of-Network Service Request (For a Lab-based Test)

Submitting a New Out-of-Network Service Request (For a Lab-based Test)

When requesting a service from an out-of-network provider, you’ll complete a detailed form to define the specifics of the test. This ensures the provider has all the necessary information to complete the request properly. Below is a step-by-step guide to filling out the New Out-of-Network Service Request form within the TPA dashboard.

1. Employer

Select the Employer (your client) from the dropdown list. This associates the test with the correct organization for tracking and billing. Only clients that have been added to your Veriport account will be available here.

2. Donor

Choose the Donor who will be tested. This list will populate based on the selected employer. If the donor has not yet been added, you may click the "New Donor" button to add a new donor to this client.

3. Service

This field is automatically populated with the service you selected from the provider's offerings. Double-check that it reflects the correct test (e.g., 12-panel POCT, breath alcohol, urine DOT collection).

4. Reason for Test

Select the appropriate Reason for Test from the dropdown menu. Options may include, based on the requester's account settings:

  • Pre-employment
  • Random
  • Post-accident
  • Reasonable suspicion
  • Return-to-duty
  • Follow-up

5. Testing Authority - For Regualted Testing

Choose the relevant Testing Authority to ensure the test is conducted under the correct regulatory framework. Common authorities include:

  • DOT – U.S. Department of Transportation
  • HHS – Health and Human Services
  • NRC – Nuclear Regulatory Commission

6. DOT Agency (if applicable)

If the selected Testing Authority is DOT, you must also specify the DOT Agency. Examples include:

  • FMCSA – Federal Motor Carrier Safety Administration
  • FAA – Federal Aviation Administration
  • FRA – Federal Railroad Administration
  • FTA – Federal Transit Administration
  • PHMSA – Pipeline and Hazardous Materials Safety Administration
  • USCG – United States Coast Guard

Finalizing the Request

Once all fields are completed:

  1. Review the information for accuracy
  2. Click Submit to send the request to the provider
  3. The provider will receive it under their Out-of-Network Service Requests Received tab

Make sure to monitor the request status and respond promptly to any proposed changes from the provider.


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