How to Complete New Client Paperwork
Client Information Form
Section 1: Account Information
Basic Information that is required to set-up a new account.
Mandatory for Initial Account Approval
Section 2: General Contact Information
Contact Person is Individual to Receive ‘Welcome to Aeon’ Call
Account Type: Record what type of account is being signed up is – examples include but not limited to Physician Specialty, Treatment Center, Nursing Home
Record requested services, monthly volume and payer type percentages.
All Information is Mandatory for Initial Account Approval
Section 3: Billing/Clinical Contact Information
Billing/Clinical Contact is used by Aeon Billing Department when Payers Require Additional Medical Necessity or Medical Notes
Contacted when Lab Requisition Form is incomplete or has incorrect Insurance Information or missing ICD-10 Code. This information is vital to submitting claims, being reimbursed by the payer which impacts commissions.
All Information is Mandatory for Initial Account Approval
Section 4: Reporting Presences
Web Portal is most Preferred by Clients & Aeon
Capturing Clients Desired Username & Password is Preferred and not Required
Client Services Administrator will Provide to Client during On-Boarding Process
Section 5: EMR Information
EMR Information is Required when Integration is Requested by Client
3 Types of Integration: Uploading of Lab Results. Ordering within EMR, Patient Demographic Capture
EMR Integration must be Approved Internally
Section 6: Shipping Information
Shipping Information Required for Initial Account Approval
Section 7: Sales Rep & Sales Group
Rep & Sales Group Name/Email Mandatory for Approval
Information used by Client Service Administrator to complete Field Communication that account has been successfully On-Boarded
Mandatory for Initial Account Approval
Physician Authorization Form
Section 1: Account Information
Basic Information that is required to set-up a new account.
This is same information required on CIF but is still needed on the Physician Authorization Form because it links account to Physician Information
Mandatory for Initial Account Approval
Section 2: Electronic Order Entry Authorization
It is required that prescribing physician authorizes individual(s) to access the Aeon Web Portal to view and create orders under the physician’s NPI #.
Authorization is also required to allow individual(s) to add and edit site users access.
Level 1 user is the account’s administrator and has full access to the accounts ordering and reporting portal. They have full administrative rights to create a new user, delete a user, define the rights of a user: examples include: Employee #1 can only create orders; Employee #2 can only view results; Employee #3 can create orders and view results.
Level 2 user is typically limited to only ordering and/or viewing lab results.
If client will be ordering via Aeon portal it is Mandatory to capture the name of the Level 1 and Level 2 users.
Section 3: Physician Order Record
Capturing every ordering physician’s name and signature is mandatory to have a new client approved.
Capturing every ordering physician’s NPI # is mandatory to have a new client approved.
Capturing the name, signature, NPI# and/or PA, ARNP# for mid-level providers is mandatory if they are to be ordering tests.
Supply Requisition Form
Section 1: Account Information
Basic Information that is required to set-up a new account.
This is same information required on CIF and the PAF but is still needed on the Supply Requisition Form.
ON INTIAL ORDERS ENSURE ‘YES’ IS MARKED AS PROCEDURE HANDBOOKS WILL BE SENT SPECIFIC TO REQUESTED TESTING SERVICE.
Mandatory for Initial Account Approval
Section 2: Supplies Applicable to:
- Specimen/Absorbent Bags are used to place a sample/specimen in after it is collected from the patient.
1 specimen bag is used for 1 patient sample/specimen.
- Clear Liner Bags are used to provide another layer of protection when preparing and shipping samples. A clear liner bag is used to house up to 10 samples/specimens.
1 clear liner bag is used to pack up to 10 patient sample/specimen.
- Lab Shipping Bags are used to ship samples/specimens. Specimen/Absorbent Bags that contain a patient sample are placed into the Lab Shipping Bag when being prepared to ship to Aeon.
1 lab shipping bag can hold up to 10 specimen/absorbent bags (10 patient samples).
- Shipping Boxes are used to ship samples/specimens back to Aeon. Once samples are properly prepared using specimen/absorbent bags; clear liner bags; lab shipping bags – they are placed into the shipping box for final shipping preparation. Shipping boxes can hold up to 10 patient samples.
1 shipping box can hold up to 10 patient samples.
- Return Shipping Labels are used to ship samples/specimens back to Aeon. The return shipping label is place on the shipping box to finalize the packing and preparation of samples to be shipped to Aeon.
1 return shipping label is used for 1 shipping box
How to Complete New Client Paperwork
Supply Requisition Form continued
Required Supplies for Toxicology:
- Toxicology specific Lab Requisition Form
- Clear Urine Specimen Cups
- If Oral testing then Oral Fluid Collection Devices (Quantisal)
*Drug Test Cups and Drug Test Dip Cards are purchased by the client.
Required Supplies for Pharmacogenomics:
- Pharmacogenomics specific Lab Requisition Form
- Buccal Swabs (2 per patient)
Required Supplies for Cancer Genomics:
- Cancer Genomics specific Lab Requisition Form
- Buccal Swabs (2 per patient)
Delivery:
- It is requested that Ground or 2nd Day Air is used when requesting supplies to be shipped.
KEY UNDERSTANDINGS:
Packing and Shipping supplies are mandatory requests during the initial setting up of an account.
Each testing service will require its own set of shipping supplies.
It is recommended that Toxicology, pharmacogenomics, cancer genomic samples are packaged in their own Clear Liner Bags & Lab Shipping Bags.
Each sample/specimen must be accompanied with a lab requisition form.
N/C means No Charge.
It is Sales Representative’s responsibility to monitor account supplies and to leave enough time to request additional supplies.
Supply Requisition Form is required to be filled out and sent to Client Services when requesting additional supplies for an account.
How to On-Board a New Client
STEP1 Complete New Client Paperwork
As a sales representative, you are responsible for completing all paperwork correctly and completely. The below forms are mandatory when signing up a new client.
- Client Information Form (CIF)
- Physician Authorization Form (PAF)
- Supply Order Requisition (SOR)
STEP2 How to Submit Paperwork
After successfully completing the appropriate forms they are submitted to the client services administrator via email or fax. or 678.828.5922
- All Forms Are Emailed or Faxed by Sales Rep
- Submit to Client Service Administrator(s)
- Sales Rep Name & Email are Required
STEP3 New Client Approval Process
Once the Client Services Administrator receives all paperwork it is sent to Aeon Sale Leadership for review and approval.
- All Paperwork Must Be Completed in its Entirety
- Information Must Be Accurate
- Sales Leadership Approval is Required
STEP4 On-Boarding “Welcome to AEON”
The Client Services Administrator will contact the client to welcome them to Aeon.
- Client is Contacted by Client Service Administrator
- CIF Is Reviewed with Client for Accuracy
- Start Date, Supplies & Key Contacts are Confirmed
STEP5 Field Communication
The Sales Rep and/or Sales Group will receive a notification email of a successful on-boarding.
- Client Service Administrator Sends Communication
- Start Date & Supply Tracking Information
- Sales Rep Portal Access; Login to Track Activity
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