Order-Fulfillment/Delivery
Invalid Address
If an order is placed with an invalid delivery address, it will be blocked by the fulfillment center, and an Ash support team member will reach out to confirm or update the address as needed. The fulfillment center will keep kits on hold for address validation for up to 1 week, after which the order will be canceled and a new order will need to be placed with the corrected address. Note: clients are not charged for the initial canceled kit. This system just helps Ash, our clients and the fulfillment center to better manage outstanding orders.
Action:
Reach out to the patient to confirm or update their address as needed and relay the updated address to the Ash client support email ASAP. If more than 7 days have passed since the original order was placed, place a new order with the updated address.
Kit is Returned to Sender/Unable to be Delivered
If a kit passes initial address validation but cannot be delivered to the patient - either due to a missing or incorrect address field or another reason - the kit will be returned to the fulfillment center (“return to sender”.) The fulfillment center collects all returned kits in a database, and Ash runs a weekly report of all kits returned to fulfillment. If a kit is returned to fulfillment, an Ash support team member will reach out to coordinate a replacement, as kits cannot be resent or reused due to regulations around human specimen collection and transit. Note: return-to-sender deliveries tend to take awhile to return and can bounce around in transit for up to a few weeks. To get ahead of potential returns, clients or patients can also track the outbound delivery, which will show a “return to sender” status update before it has made it back to the fulfillment center. This can help ensure replacement kits get out to patients ASAP.
Action:
The Ash support team will reach out with any kits returned to the fulfillment center. Ash clients are responsible for placing replacement orders, as needed, and validating the address with the patient to avoid repeat returns. If the client or patient identifies a failed delivery prior to the kit arriving back at the fulfillment center, a replacement order can be placed proactively. Just reach out to Ash’s client support email with this update to avoid confusion when the kit does arrive at the fulfillment center. Ash does not cover the cost of replacement kits due to failed delivery, unless there are extenuating circumstances.
Kit Lost in Transit
Occasionally kits are lost in transit on the way to the patient or on the way to the lab. Unlike kits returned to fulfillment, these do not always have clear status updates on the whereabouts of the kits and will often “drop off” in tracking, potentially due to USPS not properly scanning or updating it in their system. Due to the lack of clarity, it can be hard to determine when a kit is delayed versus lost. Ash support team will work with clients on a case by case basis to determine if a kit is lot, if a replacement order is needed and how quickly to initiate a replacement order, depending on patient needs (medication refills etc.)
Action:
If you suspect that a kit might be lost in transit for any of the reasons above, reach out to the Ash client success team and let them know that you are placing an order for a replacement. Ash covers the cost of replacement kits if the original kit is deemed lost by the postal service. The Ash support team will mark the replacement kit for billing accordingly.
Sample Collection
Patient Is Missing Kit Materials
While Ash fulfillment centers have a high accuracy rate, it is possible for a kit to arrive missing a material necessary for collection. Patients should use instructions as a guide to ensure they have everything they need before starting the sample collection process. If an item is missing, Ash support team will order a replacement. Supplemental collection materials such as swabs, lancets, return labels, etc. can be mailed as individual items. If a kit is missing a collection device entirely, a new kit will need to be ordered in order to generate a new kit ID. If a patient has additional materials that they do not need, the materials can simply be discarded.
Action:
If a patient is missing materials or requires additional materials (ex: more lancets), reach out to the client support email requesting a replacement.. Ash covers the cost of replacement items or replacement kits due to fulfillment error. The Ash support team will mark the replacement kit for billing accordingly.
Patient is Confused by Kit Materials
Patients are provided step-by-step instructions, with visual and written guidance, on how to complete their sample collection, register their kit (if applicable) and return the kit to the lab. Video instructions for our most common collection devices are also available for patient use. That said, patients may still be confused about a portion of this process and reach out for guidance.
Action:
Any additional questions related to the at-home testing that cannot be answered by the client can be directed to the Ash client support email. Note: Ash will not interface directly with your patients unless you are contracted for Ash patient support, so please be sure to forward questions or start a new thread if the patient reached out via email.
Patient Fears They Collected Samples Incorrectly
Patients should follow along with the instructions to ensure they are collecting their sample correctly. Of course, we all make mistakes! It is common for patients to break swabs, lose collection tube tops, collect blood samples improperly (letting blood dry then adding more at a later time) etc. If patients are unsure if their samples can be run by a lab, new materials might be needed.
Action:
If a patient thinks that their samples might be unusable, reach out to the client support email. Adding a photo is extra helpful in these cases, as we can share them with the lab to avoid wasting a patient’s time returning samples that need to be recollected. Ash support will help determine if a reorder is necessary and provide any guidance needed to make the second collection smoother.
Lab Processing
Patient Forgot to Fill Out Sample Labels
The most common lab processing issue is missing or incomplete patient information on the collection label. Each collection device is pre-adhered with a collection label that includes the kit ID, a barcode that the lab scans to bring up the electronic order, and a space for patients to provide their name, date of birth (DOB) and collection date and time. Labs use these labels to match the patient information on the physical sample with the patient information in the electronic lab order to confirm they have the right patient and to confirm that the sample was collected within the stability window (typically about 30 days.) If these labels are not filled out, the lab will flag the samples and set them aside until information can be provided.. The lab will hold a kit with missing patient information for up to 14 days, after which the kit is discarded and a replacement kit will need to be ordered to complete testing.
Action:
The Ash support team will reach out to the client to confirm patient information, if compliant with the lab’s internal policies*. The client should confirm the information with the patient directly and relay this information to the Ash client support email ASAP. If for some reason you are aware that a patient has not filled out their labels before the kit reaches the lab, reach out to the client support email, and the Ash support team will work with the lab to resolve proactively. If it has been more than 14 days since the kit arrived at the lab, a replacement kit will need to be ordered. Ash does not cover the cost of replacement kits due to missing patient information, or other patient collection errors.
*Kit rejection criteria is a lab specific policy and whether a specific sample can be processed may vary by lab. Ask client support for assistance determining next steps.
Patient Information/Lab Order Mismatch
Another common lab processing issue is mismatching patient information. Sometimes, patients will fill out their sample labels with a name different from that of their order or registration (ex: Jack vs. John.) If the name that arrives on the samples does not match the lab order, the lab will flag the samples and set them aside until the patient’s identity can be verified. For this reason, and for state reporting obligations, it is best practice to have patients use their full legal name for all parts of the at-home testing process.
Action:
The Ash support team will reach out to confirm any mismatching information, unless it is suspected that a kit has been mixed up by patients or another means (in which case it is best to cancel the order and replace as needed.) If for some reason you are aware that the patient may be using different names or did not provide their legal name, reach out to the client support email, and the Ash support team will proactively contact the lab to correct the name information. If it has been more than 14 days since the kit arrived at the lab, a replacement kit will need to be ordered. Ash does not cover the cost of replacement kits due to mismatched patient information, or other patient collection errors.
Results
Patient Receives a TNP, QNS, Rejection
If the lab is not able to process one or more of the tests in the panel - the sample was damaged in transit, the patient never provided the sample, there was not enough quantity, etc. - the lab will issue a rejection. Depending on your lab and panel, this may come as a separate notification or may be part of the results released for the full panel. More detail on possible rejection results and reasons specific to your panel and lab can be provided by your client success lead as part of the onboarding process.
Action:
If a patient receives a rejection, it is likely they will need a new test. Place a replacement order, as needed, to complete testing. Ash does not cover the cost of replacement kits due to rejected samples, but in some cases, replacement specific SKUs can be set up to allow clients to order partial panels.