Overview

Patients on controlled substances may be required to complete a UDS (Urine Drug Screen) and have an active CSA (Controlled Substance Agreement) on file to continue receiving prescriptions. This is intended for call center agents to handle patient inquiries and scheduling needs related to UDS and CSA requirements.

What is a UDS?

UDS (Urine Drug Screen)

• To ensure safe and appropriate medication use

• To meet clinic and provider policies for patients on controlled substances

• To identify potential misuse or interactions

When it's required:

• Before initiating or refilling controlled medications

• On a routine schedule set by the provider

• When requested by the provider due to specific concerns

What is a CSA?

CSA (Controlled Substance Agreement) is a document(s) signed by the patient that outlines expectations and responsibilities when being prescribed a controlled medication.

• Required for all patients receiving controlled substances

• Outlines patient responsibilities and clinic expectations

• Must be signed annually or as directed by the provider

• Often reviewed during in-person or virtual visits

UDS and CSA Visit Requirements

• UDS (Urine Drug Screen) and CSA (Controlled Substance Agreement) visits are required to be in-person.

• Exception: If a patient requests to do CSA appointment (do not offer or suggest a virtual visit), do not schedule it virtually without approval. Send a patient case to the provider's staff box requesting confirmation if the CSA can be completed virtually.

Common Patient Scenarios and Suggested Responses

-"Why do I need a UDS?" Response: "Urine drug screens are required under federal and state guidelines for patients receiving controlled substances. This helps ensure we’re staying compliant with prescribing regulations."

-"Can I get my refill before I do the UDS?"  Response: "Because controlled substances are regulated at the federal level, most providers are required to review your drug screen before issuing a refill. Completing the UDS ensures we’re following those legal guidelines."

-"Why do I have to sign a Controlled Substance Agreement?" Response: "The Controlled Substance Agreement is required by our clinic to stay compliant with state and federal prescribing regulations. It outlines your responsibilities as a patient and helps meet legal documentation requirements."

-"Can I do the CSA appointment virtually?" Response: "CSA visits are generally required to be in person due to regulatory requirements. However, we can check with your provider to see if a virtual visit is possible in your case. I’ll send a message to their team for follow-up."

Staff Reminders

• Never promise a refill before confirming UDS/CSA requirements with provider documentation.

• Always document actions taken and patient communication in a patient case.

• Direct any questions about test results, medication changes, or exceptions to clinical staff.