Requisition Forms

The Healthcare Providers Section (blue section) of my reply form is blank.

If not completed, you must attach the Physicians Requisition Printout, also called a prescription or lab order, to the InSure® ONE™ test Reply Form.

If you do not have the above, please contact your doctor’s office to have them provide you with the information needed on the form. You may also visit your prescriber and have them complete the form in person.

The diagnosis code in the Healthcare Providers Section (blue section) of my reply form is blank.

Please contact your Provider for this information; all fields must be completed entirely prior to returning.

The Healthcare Providers Section (blue section) has a sticker on it with the doctor’s information.

This is acceptable if the sticker includes all other required information listed in the HCP section. If not, all missing fields must be completed entirely on the form prior to returning.

I need assistance with the billing section of my reply form.

Do NOT list any secondary or supplemental insurance information, ONLY list your primary insurance information.

  1. If you have traditional Medicare-complete section 1 ONLY by writing your Medicare ID number on line 1.
  2. If you have a Medicare Advantage plan (a Medicare plan through a commercial insurer, like Blue Cross or Humana) fill out section 3 ONLY. All information you need to complete section 3, such as the address for your insurance company, can be found on your insurance card. Please note: The “subscriber” is the policyholder for your insurance.
  3. If you have Medicaid, write your Medicaid ID number on line 2.

I have primary and secondary (or supplemental) insurance. Should I include this on my requisition form?

Do not list any secondary or supplemental insurance information, only list your primary insurance information in the billing section.

Diet, Supplements & Medication

Will medications, supplements, or diet affect my test results?

Results will not be affected as there are no dietary or medication restrictions associated with using InSure® ONE™.

Insurance Coverage & Cost

How much does the InSure® ONE™ test cost through my insurance?

Great News…the InSure® ONE™ test is covered by most insurance companies once per year, so you can screen annually! You could contact your insurance company to verify this coverage by giving them our test code “CPT 82274” and test name “InSure Fecal Immunochemical Test.”

How much it will cost to screen if I do not have insurance?

You can contact the facility that provided you with the InSure® ONE™ kit and they will be able to advise what the test processing fee is, if any.

Sample Collection

Instructions state you should not take this test if your toilet uses salt water. I have a water softener in my home, can I still take this test?

You can take this test if you use a water softener in your home.

Do I apply stool or water to the test card?

InSure ONE uses a water-based sample collection method; no fecal matter should be applied to the test card. Some staining may occur on the test squares, which is normal. You will need to retake the test if there is fecal matter on the test card.

Can urine be present in the toilet when collecting my sample?

InSure ONE detects hemoglobin (blood) in your stool (and therefore the surrounding toilet water). Urine should not be present in the toilet when collecting your sample as it may cause a false positive result. Flush your toilet before making a bowel movement in clean toilet water.

Can I take this test if there is rust in my toilet?

Your toilet bowl must be free of rust as it can affect test results.

Can I proceed with sample collection if I use cleaning tablets in my toilet tank?

All cleaners, bluing agents, and deodorizers must first be removed, then flush until toilet water runs clear. You can then make your bowel movement in clean water and proceed with sample collection.

Can I still use my kit if I received it months ago?

You can proceed with screening if your test is not expired. To check the expiration date, locate the white backside of the test card where it reads “DO NOT OPEN” in red letters. Confirm that your test card is not near expiration. If expired, you will need to get a new kit from your doctor’s office, lab, or facility that provided the test.

Quick sample collection instruction assistance

Before you begin sample collection, make sure you have checked your toilet for any cleaners, bluing agents, deodorizers, and rust, then proceed. Flush your toilet twice and make your bowel movement in clean water. Toilet paper cannot go into the toilet bowl. Be sure to place any used toilet paper in one of the blue waste bags located in the BRUSH KIT. Take one of the blue brushes from your BRUSH kit and gently brush stool for 5 seconds to collect your water sample. Tap the brush once on the inner rim of your toilet seat to remove any excess water, as seen in the photo on your printed collection instructions or as seen in our online video. Lift the blue flap on your test card to reveal two white test squares. Dab the surface of square 1 with the brush water for about 5 seconds. Repeat that same process with the second brush to apply water sample to square 2. You can use the second blue waste bag to discard both brushes and then discard into your household trash. Make sure to seal your test card flap down with the label that you wrote your name, date of birth, and collection date on.

Does this test require two separate bowel movements?

InSure ONE only requires two water samples from the same bowel movement.

Can I still take this test if I have diarrhea or soft/lose stool?

You can still take this test. Simply swirl the brush in the water for 5 seconds and avoid any clumps of fecal matter. Proceed with the collection instructions above. If you accidentally get fecal matter on the first brush, use the second brush to apply both water samples to the test card.

What should I do if get stool on my brush?

NO NEED TO SCOOP THE POOP! Should you get fecal matter on the first brush, you can use the second brush for both test squares. Once you apply the first water sample to the first test square, repeat the collection process and apply water to your second test square.

Can my child take this test?

InSure ONE can be used by any individual who can make a bowel movement directly into the toilet.

Can I make a bowel movement in a diaper or bedpan first and transfer it to the toilet to collect my sample?

No, a bowel movement must be made directly into clean toilet water for sample collection. Moving the sample from a diaper, bedpan, or any other commode to toilet water may lead to cross-contamination and false results. NOTE: Adding water to a bedpan first and then making your bowel movement can still lead to cross-contamination and false results.

Brush Kits

What are the blue bags in the brush kit for?

These are trash bags to dispose of your toilet paper and blue collection brushes. You can then discard them in your household trash.

Why are there two blue brushes in the brush kit?

There are two blue brushes for sample collection; one for each test square on your test card. Should you get fecal matter on the first brush, then you can use the second brush for both test squares.

Test Results

How long does it take to get test results?

You should have results within about 2 weeks from when it was mailed in, received, and processed. NOTE: The test needs to be processed no later than 14 days or results are invalid.

Delay in test results

Results are sent to the Healthcare Provider that you listed on your requisition form. Please contact them directly.
If they do not yet have results, they can contact the facility or lab that processed your test to check the status. If Quest Diagnostics Lab processed your test, contact the Quest Results line at 866-697-8378.

Positive results

Please contact your Healthcare Provider for further guidance and to discuss next steps.

Sample Return & Business Reply Envelopes

How do I mail the test back if there is no business reply envelope in my kit?

Some facilities ask patients to return their test to the office or lab for processing. Please contact the facility that provided you with your kit to confirm the return method, If via mail, kindly have staff confirm the return mail address for test processing.

Where do I mail my kit to if the business reply envelope in my kit is blank?

Please contact the facility that provided you with your kit to confirm the return mail address for test processing.

Do I need to return my sample and the reply form in the return envelope?

You need to return your test card, reply form, and any other forms you were given in the business reply envelope within 48 hours of collection.

User Error

Can I still take the test if I opened the wrong flap of the test card (where it says DO NOT OPEN)?

Do not take the test if this side of the test card has been opened as it is meant for the facility that processes the test. You will need to obtain a new kit from the facility, lab, or doctor’s office that initially provided the test kit.

I misplaced or damaged my test card or brush kit

Please contact the facility that provided the kit to receive a new kit for screening.

Did Not Receive Kit

I never received my kit in the mail

Please contact the facility who mailed you the test to request another kit.

Don’t see your question?