Sorry you do not qualify for the COVID-19 antibody test. You have active symptoms which means you need to get a viral test. Please seek a center which does the COVID-19 viral test.
Difference between an antibody test and viral test
A viral test tells you if you have a current infection.
An antibody test might tell you if you had a past infection. It is a blood test to find out if you had COVID-19 infection in the past. An antibody test might not show if you have a current infection because it can take 1–3 weeks after infection for your body to make antibodies. Having antibodies to the virus that causes COVID-19 might provide protection from getting infected with the virus again. If it does, we do not know how much protection the antibodies might provide or how long this protection might last.
Do you have insurance? Do you want us to bill your insurance? We can bill your insurance company - it may be Out of network billing. If we get reimbursed from your insurance company, we will reimburse you the money you paid back to your account.
We may have to bill as out of network if your insurance provider is not within our network.
The charge on your credit card statement will show as North Clark Medical Group, LLC.
I authorize The Practice to collect my blood with a finger stick and/or a nasopharyngeal swab for COVID-19 screening.
I acknowledge the test is not reviewed by the U.S. Food & Drug Administration (FDA). COVID-19 antibody test is performed at a CLIA certified HIGH COMPLEXITY lab authorized to perform such tests. I authorize lab to perform COVID-19 antibody test on my specimen and communicate results.
I understand the processing of the specimen and results may take upto 2 business days.
I am the parent or legal guardian (if the patient is a minor or dependent) of the patient named above
By selecting checking the box next to “I have read and agree to the Consent Form” field when making an online appointment, I acknowledge that I have read, understand, agree, certify, and/or authorize the information. I further agree to hold harmless North Clark Medical Group, LLC, its officers, directors, employees, contractors and agents against all liability, obligations, claims, loss and expense arising out of any liability.
The Practice provides COVID-19 screenings antibody test specimen collection at several different center in Indiana, Kentucky, Georgia, Ohio, Mississippi, and Texas at specified test sample collection sites. Test samples conducted at these sites are transported
Testing schedule is Monday-Saturday from 9:00 AM to 4:00 PM.
The test fee is $119.00, payable by cash or credit card. Patients with positive test results will need follow-up with their primary care physician or will be referred to a local Clinic for further management. You should be able to receive reimbursement for COVID-19 testing from your health insurance company by sending the claim form for the test that we will be glad to provide. We may accept any insurance as out of network provider. All COVID-19 visits are provided by our providers as telemedicine visit.
Drive-through testing must be conducted in an automobile. Other means of transportation, including walk-up and bicycles is strictly not permitted. Everyone must have face mask on. Please advise at time of appointment/registration if you will have someone drive you to the location. Please stay in your vehicle during test procedure. Test recipient must present a driver’s license or state issued identification card to clinician. All paperwork must be completed online or via phone/email prior to arrival at the facility. Children are eligible for testing. All minors under 18 must be accompanied by a parent or guardian. The parent or guardian must have state issued identification.
In order to be tested, you MUST:
Schedule Your Appointment
Go online to our website and complete the registration information or call us. For healthcare worker, We provide special accommodations, let us know if you are a healthcare worker.
Testing appointments will be assessed by order of following priority:
Priority Testing: High-risk patients will be assessed and tested in the following order: 1) Priority 1 = Highest Risk a. Hospitalized Patients b. Healthcare facility worker 2) Priority 2 = Identify highest risk a. Patients in Long Term Facilities b. Patients 65 years of age c. Patients with underlying conditions d. First responders 3) Priority 3 = Assist with decrease of community spread and to ensure health of essential workers a. Critical infrastructure workers b. Individuals who do not meet any of the above criteria but have symptoms 4) Priority 4 = No complications – wanting to be tested a. Individuals without symptoms
FDA mandated COVID-19 IgM / IgG Antibody Testing Disclosure
Mediation and Dispute Resolution Agreement Your care is important to us, and we feel it is vital to your treatment that we communicate openly and honestly. As such, we request that you: Ask questions and participate in your care, be honest about your history, symptoms, and other important health information, prepare for and keep scheduled visits, and be respectful to our office staff and healthcare providers.
In exchange, we agree that we will: Explain diagnosis, treatment recommendations, and outcomes in an easy-to-understand way, listen to your questions and help you make decisions about your care, keep discussions and records private, and determine when a referral or termination of care is appropriate.
MEDIATION As a part of our emphasis on open communication, we ask our patients to sign this mediation agreement. While we do not anticipate any issues or concerns during the course of your treatment, if any arise, you (and/or your legal counsel) and your healthcare provider (and/or their legal counsel) agree to meet with a neutral mediator and work toward a solution. Whether or not a solution is found, mediation may postpone but does not remove or block your legal rights. Importantly, you agree that any usage or inference to a "claim" will be understood and read as "potential claim" until the mediation is complete. This designation allows us to begin in a less formal manner that has been shown to expedite the resolution process. Your signature on this page confirms that should a concern arise in any aspect of the care provided by this office, staff, and affiliated healthcare professionals, you agree to mediate first before pursuing legal action.
EXPERT WITNESSES Further, if after mediation, you still wish to pursue a court action relating to your care, your signature on this page confirms that you will use, as your expert witness(es) in your legal action, American Board of Medical Specialties board-certified medical witness(es) in the same specialty as Physician. Furthermore, you agree that the physicians who you select will be in good standing and adhere to all of the rules and guidelines of professional conduct of the American Board of Medical Specialties. As consideration for this agreement, we agree that we will adhere to these same guidelines in selecting our expert witness(es) for any court action relating to your care.
North Clark Medical Group / Amerejuve herein known as the practice
I hereby authorize the practice and its affiliates, employees, and agents to release information to:
For legal proceedings, law enforcement, abuse, neglect, or public health safety or for the purpose of helping me to resolve claims and health benefit coverage issues. I understand that nay personal health information or other information released to the person or organization identified above may be subject to re-disclosure by such person or organization and may no longer be protected by applicable federal and state privacy laws; this authorization is valid from the date of my or my representative’s signature below. I understand I have the right to revoke this authorization by providing written notice. However, this authorization may not be revoked if the practice, its employees, or agents have taken action on the authorization prior to receiving my written notice. I also understand I have a right to have a copy of this authorization.