Information for Providers on COVID-19 Testing Availability in Baltimore City

Updated 4.26.2020

Frequently Asked Questions

 

How can my patient be tested for COVID-19?

Testing for COVID-19 remains limited in Baltimore City. However, there are increasing options for patients to get tested:

  1. Provider referral for testing at testing tents
    • Providers credentialed in CRISP can provide referrals to certain testing tents across the state. This includes the VEIP testing sites and in Baltimore City  testing sites a
    • After receiving a referral, patients self-schedule an appointment. Patients require an appointment and confirmation number to be tested. Appointments are limited, pending test availability.
    • More information on these testing locations and how to refer patients is on the Baltimore City Coronavirus website.
  2. Call Centers
    • Any resident of the central Maryland region can call 2-1-1. Patients will be triaged based on symptoms and risk factors. Telehealth services are available to patients with moderate symptoms without insurance or without a primary care physician. Patients meeting CDC’s testing criteria may be offered a test, pending test availability
       
    • Esperanza center (667-600-2314, Monday-Friday 9 AM – 5 PM) offers a Spanish-English bilingual call center with telehealth services. Patients meeting CDC’s testing criteria may be offered a test, pending test availability.
       
  3. Urgent Care
    • Several urgent care centers offer testing on a limited basis. Patients are advised to call ahead to determine availability. Some urgent cares have telehealth options.
       
  4. Local providers can provide testing to their patients if they have access to adequate PPE and availability of NP, OP, or nasal swabs through a commercial laboratory. Swab collection must occur in the provider’s office – LabCorp and Quest will not collect NP/OP samples at their phlebotomy sites

Counsel patients to isolate before and immediately after their testing is complete. Counsel their household contacts to remain quarantined until testing results are completed. (See Isolation and Quarantine instructions below)

How do I use CRISP to get my patient tested for COVID-19?

  • CRISP Lab Order Guide
  • Providers credentialed in CRISP can place a referral for COVID-19 for their patients. The referral will generate a link for an appointment for patients.
  • Providers should follow CDC testing criteria and the Maryland Department of Health when referring patients. Testing supplies remain limited. More information on testing criteria is provided below.
  • Patients use the scheduling link to access a schedule of testing locations. These include the MDH VEIP drive-through sites and the Baltimore City testing tents. A car is not needed to access testing the Baltimore City testing tents.
  • Patients can choose a testing site and location. After selecting an appointment slot, they receive a confirmation number.
  • Patients attend the appointment
    • An appointment and a confirmation number are required for the VEIP testing sites and Baltimore City Tents
  • A paper copy of the results will be faxed back to the provider. A copy of the results will also be available in CRISP. The provider who placed the referral in CRISP should contact the patient with their test results.
  • Counsel patients to isolate before and immediately after their testing is complete. Counsel their household contacts to remain quarantined until testing results are completed. (See Isolation and Quarantine instructions below)
  • Follow up with patients after their test to monitor their symptoms. Some patients have experienced worsening of symptoms around 5-9 days after symptom onset. Patients should be instructed to call their provider or seek medical attention if their symptoms worsen or need emergency assistance.

Which patients should I refer for testing via CRISP?

  1. Hospitalized patients, who should be tested by the most expeditious means available (either a hospital lab, private lab, or the State Laboratory);
  2. Symptomatic Emergency Medical Service Personnel, healthcare workers, and law enforcement personnel;
  3. Symptomatic patients in nursing homes, long-term care facilities, or in congregate living facilities housing individuals who are medically fragile; OR
  4. Symptomatic high-risk unstable patients whose care would be altered by a diagnosis of COVID-19

 

  • Providers should not order a test or refer a patient for a tent appointment if they are asymptomatic.
  • Baltimore City Health Department also recommends that patients with mild illness and without risk factors for severe disease not be prioritized for testing. Those patients should be counseled to stay home, following isolation and quarantine instructions, and call their provider or go to the Emergency Room if their symptoms worsen.
  • Testing should be prioritized for those with moderate symptoms, and those with risk factors for severe disease.

 

Can I write a prescription for my patient for one of the testing tents?

  • Patients should not arrive at Baltimore City testing tents tent with prescriptions from their private providers.
  • Providers can refer patients to the Baltimore City testing tents by placing a referral in CRISP. The referral will generate an appointment request, and patients can schedule an appointment at the tent.  (see directions above).
  • Patients can access the Pimlico tent by calling 2-1-1. Patients meeting CDC’s testing criteria may be offered a test, pending test availability.

 

Can my patient show up at a tent without an appointment and be tested?

  • Most testing tents in Baltimore are by appointment only.
  • Patients are encouraged to get appointments for testing tents. This is to promote social distancing and reduce the risk of disease transmission at testing tent sites.

 

What about individuals who don’t have health insurance or who don’t have a primary care provider?

  • People without health insurance and/or without a primary care provider can call 2-1-1 with testing questions. Telehealth services are available to patients with moderate symptoms without insurance or without a primary care physician. Patients meeting CDC’s testing criteria may be offered a test, pending test availability.
  • The Esperanza center (667-600-2314, Monday-Friday 9 AM – 5 PM) also offers a Spanish-English bilingual call center with telehealth services for people without insurance or primary care provider. Patients meeting CDC’s testing criteria may be offered a test, pending test availability.

 

What do I tell my patients about isolation and quarantine?

  • Patients who have symptoms consistent with COVID-19 should remain in isolation. Isolation instructions include:
    • Stay home except to get medical care. Do not go to work, school, or public areas.
    • If you must leave your home while you are sick, do not use public transportation
    • If possible, practice social distancing with other household members and avoid sharing personal household items
    • Continue good hygiene including frequent and thorough hand washing, and covering coughs and sneezes
    • Disinfection of ‘high touch’ surfaces
    • Wear a mask if you need to be around others or if you need to leave the house

 

  • Close contacts of patients with suspected or confirmed COVID-19 should be given self-quarantine instructions. The purpose of the quarantine is to see if the close contact develops symptoms, and prevent the spread of illness to others. Self-quarantine instructions include:
    • Not leaving home except for seeking medical treatment. Do not go to work, school, or public areas.
    • If possible, practice social distancing with other household members and avoid sharing personal household items
    • Self-quarantine for 14 days after their last contact with the patient while the patient is infectious to others
    • Monitor for symptoms of COVID-19 such as fever, cough, shortness of breath, or trouble breathing. Other early symptoms include chills, body aches, sore throat, headache, diarrhea, nausea/vomiting, and runny nose. If symptoms develop, contact your medical provider.

 

When can home isolation stop for someone who tests positive for COVID-19?

CDC guidelines provide two options for removing home isolation guidance for patients – test-based and non-test based. The ‘test’ in this case refers to if a test is done to end home isolation. Each option is available to either confirmed patients (who had a COVID-19 test at the time of diagnosis) OR suspected patients (who were diagnosed based on symptoms and have not had a test to diagnose COVID-10).

 

  • Non-test based: (Patients will not have a test to determine if they are still contagious) Home isolation can stop when:
    • They have had no fever for at least 72 hours without the use of antipyretics
      AND
    • other symptoms have improved (for example, when cough or shortness of breath have improved)
      AND
    • at least 7 days have passed since your symptoms first appeared

 

  • Test-based: (Patients will have a test to determine if they are still contagious) Home isolation can stop when:
    • They have had no fever without the use of antipyretics AND
    • other symptoms have improved (for example, when cough or shortness of breath have improved)
      AND
    • they received two negative tests in a row, 24 hours apart.