Provider Agreement & HIPAA Terms

1. Who may hold a provider account

A provider account is for licensed prescribers and pharmacists ordering pharmacogenomic (PGx) testing for their own patients: physicians, nurse practitioners, physician assistants, pharmacists and other clinicians licensed to order laboratory testing in the state where the patient is seen.

You confirm, each time you order, that you hold a current and unrestricted licence in that state, that the National Provider Identifier (NPI) on your account is your own, and that the patient is under your care. RPh Labs verifies your NPI against the national NPPES registry when you register, and may verify your licence with the issuing board at any time.

An account may not be held on behalf of a prescriber by someone else. Practice staff who place orders must do so under their own account, or under a shared practice account the prescriber has authorised in writing.

2. Your account and credentials

Your email address is your username. You are responsible for keeping your password confidential and for everything done through your account. Tell us immediately if you believe someone else has used it.

Keep the details on your account current, in particular your licence number, DEA number, practice address and phone number. We rely on them to route reports, ship kits and reach you about a result that needs discussion.

Accounts are reviewed by our pharmacy team before they are activated. We may decline or close an account whose licence, NPI or practice details we cannot verify.

3. Ordering and provider pricing

Provider pricing applies to kits you order for patients under your care. It is offered to you as a clinician and is not transferable: kits may not be resold, marketed as your own product, or distributed outside your practice.

Prices, discounts and turnaround times are those shown in your account at the time you order. We aim to return pharmacist-reviewed results within 7 to 10 business days of the laboratory receiving a viable sample; that is a target, not a guarantee, and a sample that fails quality control will need to be recollected.

Kits are shipped to the patient or to your practice, as you choose at checkout, with prepaid return postage to the laboratory.

4. Clinical responsibility

PGx results are decision support. They describe how a patient’s genotype is expected to affect the metabolism or response to particular medications; they do not diagnose a condition, and they do not prescribe.

Every prescribing decision remains yours. You are responsible for interpreting a report in the context of the patient’s clinical picture, other medications, comorbidities, adherence and preferences, and for any change you make to a regimen. RPh Labs does not practise medicine and does not establish a clinician-patient relationship with your patients.

Our pharmacists are available to talk through a report with you. That consultation is collegial support for your decision, not a second opinion you can transfer responsibility to.

5. Patient consent

Before you order, you must obtain the patient’s informed consent to genetic testing, in the form your state and your own policies require, and confirm that the patient understands what is being tested and who will receive the report.

You confirm that you have the patient’s authorisation, or another lawful basis, to disclose to RPh Labs the information needed to run the test and to bill for it, and to receive the report back.

Genetic information carries protections beyond HIPAA, including under the Genetic Information Nondiscrimination Act (GINA) and state genetic privacy laws. You are responsible for handling a patient’s results in line with those protections inside your practice.

6. HIPAA and protected health information

In performing testing that you order, RPh Labs acts as a health care provider and a covered entity in its own right, not as your business associate. Each of us is separately responsible for complying with HIPAA for the protected health information (PHI) we hold.

We exchange only the minimum PHI necessary to order a test, run it, return the report and bill for it. We do not sell PHI and we do not use it for marketing without written authorisation.

You agree to send PHI to us only through the channels we provide, to use your provider account rather than unsecured email for anything identifiable, and to keep any report you download inside your own safeguards once it leaves our systems.

If either of us discovers a breach of unsecured PHI affecting the other’s patients or records, we will notify the other without unreasonable delay and cooperate on the notifications the law requires.

Our full Notice of Privacy Practices explains how we handle PHI and the rights patients have over it.

Read the full HIPAA Policy and Notice of Privacy Practices.

7. Reports and records

Reports are released to the ordering prescriber. They are stored encrypted, and are available under My Reports in your account. Access them from your account rather than forwarding them by email.

The report is part of the patient’s medical record. You are responsible for filing it in your own records and for retaining it as long as your state and your specialty require.

The laboratory retains the report and the underlying data in line with CLIA and state record-retention requirements.

8. Payment and billing

Orders placed through your provider account are payable at checkout unless we have agreed other terms with you in writing.

Where a test is billed to a patient’s insurance, you are responsible for the accuracy of the diagnosis codes and clinical documentation supporting medical necessity, and for the Advance Beneficiary Notice where Medicare requires one.

Nothing in provider pricing is offered in exchange for referrals. Neither party may offer or accept anything of value to induce an order, consistent with the federal Anti-Kickback Statute and Stark Law.

9. What you may not do

• Share your log-in, or let anyone order under your NPI who is not authorised to.
• Order for a patient who is not under your care, or in a state where you are not licensed.
• Resell kits, or present RPh Labs testing as your own laboratory service.
• Use provider pricing for anything other than patient care in your practice.
• Send us identifiable patient information through an unsecured channel.
• Use a report, or our name or marks, in advertising without our written permission.

10. Suspension and termination

Either of us may close the account at any time. We may suspend it immediately, without notice, if a licence lapses or is restricted, if we cannot verify your credentials, if the account is used in a way this agreement prohibits, or if patient safety requires it.

Closing the account does not affect orders already placed, your obligations for PHI you already hold, or the sections of this agreement that are meant to survive it.

11. Changes to these terms

We may update this agreement. The version in force is the one published here, and the date below says when it last changed. Material changes will be emailed to the address on your account. Continuing to order after a change means you accept it.

12. Contact us

Questions about this agreement, your account, or a report: call (888) 383-2181 or message our pharmacy team. For privacy questions, contact our Privacy Officer at [email protected].

Call (888) 383-2181 or message our pharmacy team.