H T Hackney/J.J. Keller & Associates Inc (H T Hackney) – Utilizing Newton Clinic
Services:
– DOT URINE DRUG COLLECTIONS:
– Pre-Employments
– Randoms
– Reasonable Suspicion/Cause
– Post Accidents
– Return to Duty
– Follow-up
– Salvia Alcohol Test DOT (Excludes pre-employment)
– DOT Physicals
Billing Information – Send invoices for DOT urine collections, Alcohol tests, and DOT Physicals to:
– J.J. Keller & Associates, Inc.
Mail Stop #1520
Attn: Clinic Billing
P O Box 368
Neenah, WI 54957-0368
Invoice must include Donor Name, ID, Company Name, Service Date, Service Type and Amount.
• Additional documents requested to be included with invoice; copies of Chain of Custody forms, Alcohol
testing form and employer authorization letters.
• Bills with dates of service older than six months may be denied payment.
• Direct questions on billing and payments received to clinicbilling@jjkeller.com or call 920-727-7398.
J. J. Keller is not responsible for payment for Non-DOT collections or Workers Comp Services rendered at your facility.
Alcohol INSTRUCTIONS:
Alcohol Test results GREATER than .02 please call DER: BRIAN HUDSON @ 803-206-0404
If the DER is unavailable, please call Managed Services at 800-218-0779 for further instructions.
Donor will have the
ALERE chain of custody form and authorization form with them at the time of
testing.
If the donor does not have the chain of custody form with them, please contact
J. J. Keller & Associates, Inc. at 800-218-0779.