Annandale Family Medicine

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Your Golden Care Team will work with you over the phone as often as you need to help provide the outcomes you deserve. Your Golden Care Team will also: 

• Ensure you are receiving any services you are entitled to or are needed to provide you with the best possible care. 
• Ensure your records are accurate and up to date and your Annual Wellness Visit and other Medicare requirements have been completed. 
• Listen to your concerns and help you achieve your health goals.
• Make sure you understand your care and work with you to reduce your out-of-pocket health care expenses. 
• Help make sure remote patient monitoring, chronic care management or other services that may be beneficial to your health are made available at no additional cost to you. 
• Review screenings, labs, and other services needed, while answering your questions and addressing your needs.
• Make sure you understand your care and work to help you with next steps.

Your Golden Care Nurse Practitioner provides us all this information, allowing us to spend more time with you providing direct clinical care, which leads to better health, better understanding of your care, less health care issues, less out of pocket expenses and an overall healthier you.

What are Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) Services? 

CCM and/or RPM services are provided to patients who have one or more chronic conditions and are at significant risk of acute exacerbation/decompensation, or functional decline. CCM/PRM services include face-to-face visits—virtually or in person—as well as innovative technology that allows patients to monitor and take control of their own health in their own homes.  

You will be provided with a CCM/RPM care coordinator that reports directly to your primary care provider and will work with you in between your regular office visits. Your care coordinator’s primary function is to provide the additional care necessary to: 

• Coordinate information and referrals between your entire care team 

• Work with you regularly on your care plan, health care goals and health concerns 

• Ensure you have 24-hour access to your care team 

• Provide disease specific education and preventive health services 

• Monitor your health and help reduce emergency room visits and hospital admissions 

• Help reduce the expenses you currently pay for your care 

• Help you achieve your health goals and improve your quality of life 

Your care coordinator will also determine if it will be beneficial for your care for you to receive special health devices, such as a glucometer, blood pressure cuff, weight scale or other equipment that sends readings directly to your care team for them to monitor live in real time. 

Because of the importance these services may have on your overall health and the benefits they should provide to you, we are having these services provided at no cost to you, for as long as you may need them. 

 You will not receive a bill from Golden Care, which is a non-profit medical practice, that specializes in providing services that assist other medical practices around the country to provide the best care possible for their senior or “at risk” patients.  We bill Medicare or insurance carriers for our services just like all other medical practices.  The services we provide are as a contributing partner with your local medical practice. All of our services are covered by Medicare, your insurance carrier or your local clinic.  You will never be asked to pay any out-of-pocket expenses for services you receive from Golden Care. 

Did you receive a letter from Medicare or your insurance carrier that you don't understand or are concerned it's a bill you need to pay?

This letter might be an Explanation of Benefits (EOB).

This letter explains what was paid to your provider on your behalf, and what if any of these charges were not paid. The EOB you received from Medicare, or your insurance carrier is not a bill. Even if the EOB states a patient responsibility amount, or amount you may be billed, this is not a bill. It is only an explanation of charges and benefits associated with the medical services you received.   

Golden Care works with medical practices, hospital systems and other health organizations across the entire United States. The provider listed on your EOB is either the provider that completed your services or the supervising physician of the provider that completed your services. Even though the services provided were completed in your state of residence, the EOB might state the address as being in Minnesota, California or Florida, these are corporate locations for billing reconciliation only, not service locations. If you have any questions about your E.O.B. or need additional assistance, please call 866-305-0622.

Annual Wellness Visit(AWV).  Annually

Ultrasound Screening for Abdominal Aortic Aneurysm (AAA). Medicare beneficiaries with certain risk factors for AAA. Requires referral. Once in a lifetime

Cardiovascular Screening Blood Tests. All Medicare beneficiaries without apparent signed or symptoms of cardiovascular disease. Every 5 years 

Diabetes Screening Tests Medicare beneficiaries with certain risk factors for diabetes or diagnosed with pre-diabetes. 2 screening tests per year for beneficiaries diagnosed with prediabetes.  1 screening per year if previously tested, but not diagnosed with prediabetes or if never tested.

Diabetes Self-Management Training (DSMT). Medicare beneficiaries diagnosed with diabetes.  Up to 10 hours of initial training within a continuous 12 months Subsequent years: up to 2 hours of follow-up

Medical Nutrition Therapy (MNT). Certain Medicare beneficiaries diagnosed with diabetes, renal disease, or who have received a kidney transplant with the last 3 years. 1st year: 3 hours of one-on-one counseling. Subsequent years: 2 hours 

Screening Pap Tests. All female Medicare beneficiaries. Annually if at high-risk for cervical cancer. Every 2 years for all others

Screening Pelvic Exams. All female Medicare beneficiaries. Annually if at high-risk for cervical cancer. Every 2 years for all others

Screening Mammography All female Medicare beneficiaries age 35+.Age 35-39 1 baseline. Annually for age 40+ 

Bone Mass Measurements. Medicare beneficiaries at risk for loss of bone mass Every 2 years or more frequently if medically necessary 

Colorectal Cancer Screening. Medicare beneficiaries age 50+. Every 2-10 years depending on risk 

Prostate Cancer Screening PSA Test All male Medicare beneficiaries age 50+ Annually 

Glaucoma Screening Medicare beneficiaries with diabetes, family history, African Americans 50+, Hispanics age 65+. Annually 

Influenza Vaccine. All Medicare beneficiaries. Once per influenza season 

Pneumococcal Vaccine. All Medicare beneficiaries. 1 Initial vaccine and 1 different 2nd vaccine 1 year later 

Smoking Cessation Counseling. Medicare beneficiaries who use tobacco. 2 sessions per year 

HIV Screening. All Medicare beneficiaries. Annually or 3 per pregnancy 

Behavioral Therapy for Cardiovascular Disease. Men age 45-79, Women age 55-79, others at high risk. Annually 

Alcohol Misuse Screening. All Medicare beneficiaries. Annually 

Depression Screening. All Medicare beneficiaries. Annually 

Behavioral Therapy for Obesity. Medicare beneficiaries with a BMI index over 30. Up to 22 sessions in 12 months 

Preventive Screening Guidelines

Weight 

Try to reduce your sugar intake. Sugar increases your risk   of diabetes and increases your waist size. Consider switching to diet sodas   and sugarless snacks. 

We   all know fried food is tasty, but it puts you at high risk for heart disease   and heart attack. Substitute chicken or fish whenever you can.  

Nutrition 

Weight gain can be avoided by increasing your exercise   level and keeping your meal portions small. Eat small portions of food 4-5   times per day instead of 3 large meals. Skip desserts. Eat fruit, nuts and   raisins as snacks. A small amount of nuts per day can help reduce your risk   of heart disease, lower your "bad" cholesterol and increase your   "good" cholesterol. 

Green   leafy vegetables should be a part of your diet every day. Try to eat 1-2 servings   of these to help your heart and reduce your risk of diabetes. 

Fall Prevention 

You should take extra precautions around your house, bathroom and outside on your walkway to have railings installed so you don't   fall and suffer a setback. 

Be   aware that slippery surfaces can lead to falls and those can lead to   hospitalization, long term care facilities and even nursing homes. Use   handrails and stay off the ice! 

Cognition 

You   did not express any concerns about your cognition and no immediate concerns   or issues have been identified. Your provider will work with you to further   evaluate your cognition as needed or requested.  

Depression 

Your   outlook on life is important to your well-being. If you have a negative   outlook, tell your provider immediately. You may have early signs of   depression. 

Physical   Strength 

Your   age is 65 years or older. As you age your bones become brittle and you have   muscle loss. Your provider can discuss ways that you can help strengthen   bones and muscles.
 

Referrals 

Your   provider may request additional screenings based on your medical conditions   and screening history. The other side of this page explains potential   recommended screenings and Medicare recommended guidelines. Your provider   will go over these with you as needed.