Lifespan Laboratories

Home Draw Policies

Homedraw services are available Monday through Friday from 7 a.m. to 3:30 p.m. Any requests made after 2:30 p.m. cannot be guaranteed for the next business day. The homedraw department will make a concerted effort to schedule a homedraw for the desired dates requested.

Lifespan Laboratories will only perform homedraw services for those patients that meet the criteria of homebound. See the Medicare Benefit Policy Manual, Chapter 7, Section 30.1.1 for more information.

All orders must be submitted on a Lifespan Laboratories homedraw requisition and signed by an authorized health care provider. Orders should be faxed to 401-793-4741. No verbal orders can be accepted. Incomplete requisitions will delay the scheduling of a homedraw.

Download the homedraw requisition form (PDF)

All requisitions must include the following information:

  • Ordering physician
  • Physician address
  • Physician phone number
  • Physician fax number
  • Clinic code if you receive your results via electronic medical record (EMR)
  • Check off “standing order” or “one-time draw”
  • Patient name
  • Patient gender
  • Patient address
  • Patient phone number
  • Patient date of birth
  • Patient social security number
  • Insurance name
  • Insurance number
  • Is the patient a subscriber? If no, name of subscriber, address and relationship to patient
  • Does the patient have secondary insurance? If yes, please complete the appropriate section on the requisition
  • Test(s) requested
  • Appropriate diagnoses (ICD-9 codes)
  • Signature and date

NOTE: If the request is for a standing order, the following additional information is required:

  • Check off “new standing order” or “renew standing order”
  • Order start date
  • Order end date (can not exceed six months)
  • Frequency (PRN is not an acceptable frequency)

For questions or problems with the requisition form, please contact Lifespan Laboratories customer service at 401-793-4242.