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PATIENT HANDBOOK Treating your cancer, caring for your life


DRIVEN BY EXCELLENCE. INSPIRED BY YOU. New England Cancer Specialists is a physician-owned, patient-centered medical practice, recognized as a leader in cancer care, treatment, and research. With nearly half of Maine’s medical oncologists and hematologists on our team, we are the region’s largest oncology group, serving people in need throughout New England.

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As our patient, you will have wider access to state-of-the-art treatment that is closer to home and centered on your individual needs. Our commitment to excellence is inspired by you.

ONCOLOGY MEDICAL HOME

MAINE’S ONLY ONCOLOGY MEDICAL HOME We’re honored to be the only practice in Maine recognized as an Oncology Medical Home by NCQA (the National Committee for Quality Assurance).


We’re proud to be a member of the Dana-Farber Cancer Care Collaborative, in recognition of our “demonstrated commitment to excellence by meeting a wide range of standards and best practices in adult medical oncology.” This formal recognition of our long-term collaboration with Dana-Farber means even greater access to their specialists in complex cancers, clinical trials, tumor board conferences, and more...all of which will enhance our ability to help patients beat cancer and enjoy a long and rewarding survivorship.

TABLE OF CONTENTS OUR ONE GOAL: YOUR BEST OUTCOME PRESCRIPTION SERVICES LABORATORY SERVICES CLINICAL TRIALS GENETIC COUNSELING SURVIVORSHIP CARE FINANCIAL POLICY & ADVOCACY 2


OUR ONE GOAL: YOUR BEST OUTCOME

WE TAKE YOUR CANCER PERSONALLY. Since we opened in 1967, we have focused our practice on one goal: to achieve the best possible outcomes for our patients. With more clinical trials than anywhere else in Maine, we are often the first to offer leadingedge protocols and drug treatments based on the newest information and research. • O  ur team of specialists includes board-certified oncologists and hematologists who are nationally recognized for their expertise and experience. • We have achieved best-in-the-nation QOPI® (Quality Oncology Practice Initiative) certification for oncology and hematology care. • We offer advanced therapies and drugs as well as expanded access to new programs and clinical trials. Simply put, we don’t give up. When it comes to fighting your cancer or blood disorder, we are relentless in our determination to achieve the best possible outcome available.

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WE ARE PHYSICIANOWNED AND PATIENTCENTERED—THE BEST COMBINATION FOR INNOVATIVE, COLLABORATIVE CANCER CARE.

INDEPENDENCE MAKES US TOUGH ON CANCER. As an independent oncology group, we are free to collaborate with other top cancer and hematology specialists at treatment and research facilities across the US. Our mission is to bring the best minds together to foster innovation and research breakthroughs that will benefit our patients. We share best practices through participation in national and regional organizations dedicated to improving cancer care, access and cost. Our physicians are active members of national organizations (such as ASCO, COA and ACCC), working toward improved care, expanded access, and payment reform. Our independence is your assurance of the latest and most innovative treatments available today.

WE TREAT THE CANCER— AND CARE FOR THE PERSON. Quality of life matters. That’s why we focus on your well-being—physical and emotional—as we fight your disease. Our three full-service treatment centers in Maine make the highest quality care more accessible, reducing travel hours and time spent in hospital settings. We have evening and weekend hours for your convenience, and are available 24 hours a day for urgent care. Your own personal care team will coordinate all aspects of your care, working with you and your family, every step of the way, and we offer support services such as genetic counseling, financial advocacy, and an on-site prescription dispensary. 4


PRESCRIPTION SERVICES

MEDICATION MANAGEMENT IS KEY. We have an on-site patient prescription dispensary in our Scarborough location, which enables you to fill your prescription before you leave our office. For Scarborough patients, this means no long waits for mailorder prescriptions, no extra stops on the way home, and a better way to manage your medications. We also prepare and deliver medications for Kennebunk and Topsham patients to pick-up at their appointments. Many patients take a combination of medications prescribed by us or other doctors. Through our dispensary, we can better manage your cancer treatment by having a complete and accurate list of all the medications you are taking, kept up-to-date in our records. We’ll also help you understand your medications, and explain how to take them correctly to avoid problems and achieve your best possible outcome. The more we know about the medicines you are taking, the better we can manage your care. Here’s why: • Some medicines can decrease the effectiveness of your chemotherapy treatment. • Some medicines cause side effects similar to those from chemotherapy, creating more discomfort for you. • Other medicines may actually enhance chemotherapy effectiveness. • Some herbal medicines, even some foods, can change the way your body absorbs and uses medication.

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THE BENEFITS OF USING OUR PRESCRIPTION SERVICES Costs: We are able to offer most medications at a lower cost than you pay elsewhere. We also offer financial assistance. Co-Pays: While we can’t change or waive co-pays determined by your insurance company, we will help you apply for assistance, if needed. Convenience: You can pick up your medications before you leave our office. And if you have questions, you can get them answered right away. Support: We share tips and tools to help you stick to your medication schedule; we also offer medication reminder programs. Education: We will help you know what to expect from your medications and how to manage side effects. And we will follow up with you by phone or email. There are some medications we can’t carry. These include Narcotics, due to liability and security restrictions, and Select Chemotherapy Drugs, as some insurance companies may require you to use a specialty pharmacy.

For prescription refills or answers to questions about your medications: call us at (207) 396-7534.

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LABORATORY SERVICES

ACCURATE RESULTS ARE CRITICAL TO SUCCESSFUL TREATMENT Each NECS location has a fully equipped laboratory on site, with our main lab located at our Scarborough location. Blood draws are performed by medical assistants who are skilled at successfully drawing from even the most challenging veins. Nearly 95% of the tests your physician orders are run in our labs, which means results will be available to your provider much faster. Analyses are performed by board-certified Medical Technologists who are highly skilled in performing a variety of complex testing for the diagnosis and management of diseases. For labs not run on site, we participate with various national reference labs and specialty labs so our physicians have timely access to the testing they need to help drive treatment decisions. We welcome lab prescriptions from your other providers, which will reduce the number of your blood draws. We will run these tests either in our lab or forward samples to a reference lab for you, and send the results back to your provider. To take advantage of this service, please mention you have labs to draw from another provider and bring a copy of your outside prescription when you come for your draw. Our labs operate seven days a week, except major holidays. Blood draws are done from 7:45am–5pm weekdays, and from 9am–1pm during our urgent care clinic on weekends. Please schedule your draws ahead of time to avoid waiting.

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THE CONVENIENCE OF PORTS... AND PORTALS If you have a port, we have designated personnel to draw blood, which may be done in the lab, treatment room or exam room. If you don’t have a port, don’t worry—our phlebotomists are highly skilled at drawing blood painlessly. A secure patient web portal lets you review your lab results from anywhere, 24/7/365. It’s easy to use and we’ll provide detailed instruction. Results of lab tests done at NECS will be available immediately; results of tests done at an outside lab may take several days to be posted on the portal. (Please note that the lab cannot advise you on medication or medical issues, which should be discussed with your physician or the triage nurse.) Paper lab results will be sent only if you request them. Copies of your lab results will also be available at your appointments. If your primary care physician wants you to have additional testing done at the time of your NECS visit, please inform the Medical Assistant so that we can order it and make sure the result is sent to your primary care provider.

INSURANCE MATTERS We want to make sure your insurance company covers its share of testing costs, so please notify us of any changes to your insurance. Often your insurance will determine where outside lab tests will be sent.

Your satisfaction is important. The lab manager is available during regular working hours if you need special attention. Please call us at (207) 303-3300 with any questions or concerns. 8


CLINICAL TRIALS

LEADING-EDGE RESEARCH CLOSE TO HOME As the region’s leader in cancer treatment, New England Cancer Specialists is dedicated to contributing to new discoveries in cancer research. Through investment and collaboration with our research partners, we strive to offer hope and improve patient outcomes. As part of this effort, we support a robust portfolio of clinical trials developed by our national and international sponsors that we can offer to our patients closer to home. We believe you should be aware of all your treatment options, including participation in a clinical trial. We offer many trials, which fall into three broad categories: • Treatment/Intervention: These trials test new medicines, different combinations of medicines, or a different order of therapy in an attempt to improve patient outcomes. • Observational: These studies follow patients receiving standard treatments by collecting de-identified data. There is no change in treatment because of the study. • Translational: These studies involve the collection of blood and/ or tissue samples along with de-identified data to explore how differences in a patient’s genetics may affect diagnosis, treatment and response. There is no change in treatment because of the study.

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“IS A CLINICAL TRIAL RIGHT FOR ME?” We understand clinical trials aren’t for everyone. Some patients are eager to enroll. Others are pleased to contribute information, but don’t want to be in a treatment study. Some want to share thoughts and feelings in observational studies. Some patients are willing to provide a blood sample if it may help advance our knowledge of cancer. It’s important for you to understand that taking part in a clinical trial is voluntary. If you decide to take part in a trial and then change your mind, you can also drop out of the trial at any time. Whatever decision you make, your doctors and nurses will make sure you get the best care possible for your disease. For details about the clinical trials currently available, please visit the Clinical Trials page on our website, and click on “View current clinical trials” at the bottom left.

If you have questions about our research efforts, including clinical trials, please call our Research Coordinator at (207) 303-3300.

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GENETIC COUNSELING

WHAT TO EXPECT Our board-certified genetic counselor can help you and your family understand your chance of developing cancer due to a genetic condition (hereditary cancer syndrome). She will meet with you to review: • P  ersonal and family medical histories • The genetic basis of cancer • The likelihood that the cancer in a family is due to an inherited change (also known as a mutation) in a cancer susceptibility gene • The risks for you and family members to develop cancer • The chance that genetic testing will be helpful, and its risks, limitations, and cost • Personalized cancer screening, risk reduction, and prevention strategies

WHO GETS CANCER? One in three people will develop cancer at some point in their lifetime, but only 5–10% of cancers are hereditary; most are “sporadic” cancers, caused by changes in a gene as a result of the environment (e.g., ultraviolet exposure), behavior (diet, tobacco or alcohol exposure), or by chance. Signs of a hereditary cancer syndrome are: • E  arly age of cancer diagnosis (before age 50) • Multiple family members with the same or related cancers (e.g., breast and ovarian, or colon and uterine) • Cancer in multiple generations • More than one cancer in a single individual • A rare cancer (like male breast cancer, adrenocortical carcinoma, sarcoma, hemangioblastoma, and others)

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“IS GENETIC TESTING RIGHT FOR ME?” Your genetic counselor will talk with you about different issues so you can make an informed decision about genetic testing. Questions to consider: • If I decide to have testing, what would I do with that information? • How will the result affect me emotionally? • How and/or when will I share this information with my family? Insurance Coverage Most insurance companies will cover genetic testing when your genetic counselor determines there are substantial risk factors in your personal or family history. Protection From Genetic Discrimination There are laws that forbid health insurances and businesses from discriminating based on genetic information. Your genetic counselor will discuss this with you in more detail.

To learn more or to schedule an appointment, please speak to your care team or call us at (207) 303-3300 with any questions or concerns.

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SURVIVORSHIP CARE

WE HELP CANCER PATIENTS THRIVE—NOT JUST SURVIVE. We recognize that the completion of treatment for cancer can be an exciting time: you have been through a tough process and come out the other side. It can also bring unexpected challenges as you adjust to your life after treatment. Treatment options have improved, so patients are living longer—in fact, there are an estimated 16 million cancer survivors in the US today. Many experience lingering effects from their treatment. That’s why we offer Survivorship Care for all our adult patients who have completed treatment. Your care team will help you adjust to your new “normal,” transition back to the life you fought so hard to save, and create the future you want.

WHAT WILL YOUR SURVIVORSHIP CARE SPECIALIST DO? When your treatment concludes, your care team will work with you on a detailed follow-up care plan that you can share with your Primary Care Provider and other providers. Your team will take the time to answer any questions you have about this plan. Our goal is to make sure you have all the tools and information you need to thrive after cancer. Depending on your needs, we will offer ways to manage the common consequences of cancer treatment, such as: • D  istress, anxiety or depression • Dependence on tobacco, medication or alcohol

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“ FROM THE MOMENT OF DIAGNOSIS AND FOR THE BALANCE OF LIFE, AN INDIVIDUAL DIAGNOSED WITH CANCER IS A SURVIVOR.” NCCS, 2013

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Financial stress Nutritional needs and weight management Fatigue, pain or a lack of physical fitness Sexual dysfunction

Finally, we’ll offer resources in the community to assist you in reaching your survivorship goals. The cancer journey can bring many changes to your life and the lives of your family and friends. New England Cancer Specialists wants to help you thrive and live the best life you can going forward. Our Survivorship Care Specialists are dedicated to empowering every patient to move from illness to wellness.

To learn more or to schedule an appointment, please speak to your care team.

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FINANCIAL POLICY & ADVOCACY

OUR FINANCIAL ADVOCATES EASE YOUR MIND. At New England Cancer Specialists, we understand that having cancer is stressful enough without having to worry about paying for treatment. That’s why we offer patients the free services of our trained Financial Advocates. Our Financial Advocates are here to help answer any questions you may have about covering the cost of your care. They are specially trained to review your insurance coverage, alert you to any unexpected costs, and help you find financial assistance when necessary. You should know that: • F  inancial assistance is available for nearly all insured and uninsured patients, even with incomes greater than $100,000. • Programs are based on household income, insurance status, and diagnosis. • Co-pay relief programs are available. Many financial support programs are available to help cancer patients, from assistance with travel, co-pays, and deductibles, to chemotherapy drugs, prescriptions, and even family care and food needs. Financial Advocates in each office are dedicated to helping you find and access these resources: • F  inancial assistance programs can cover out-of-pocket medication and treatment costs, as well as non-medical expenses. • National and local foundations may have funds available. • Some patients qualify for free medications from pharmaceutical companies. • Our own Financial Assistance Program can help with the cost of your physician visits and drug administration charges.

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INSURANCE MATTERS Your health insurance policy is a contract between you and your insurer. We will bill your plan for you, so please provide us with up-to-date information. If you prefer to bill your insurance company independently, please do so promptly so that you will receive timely reimbursements. As the patient, you are responsible for payment of all services provided by our facility. Please consider the following: Medically Necessary Care We only provide services that we consider medically necessary. However, there may be occasions when your insurance company determines a service to be unnecessary. In this case, you may be responsible for any costs not covered by your insurance company. Disputed Claims We will do our best to help you with disputed insurance claims. Our Patient Accounts Department is available to discuss any questions you may have regarding your insurance or your account.  Pre-authorizations Once you and your physician have chosen your treatment, we will obtain all the necessary pre-authorizations. Referrals If your insurance plan requires you to choose a primary care physician (PCP), you may need to obtain a referral before seeing us. Please complete the referral before your appointment, as all charges incurred without a required referral will be your responsibility. We will help by following up with your plan. Changing your Primary Care Provider (PCP) If you are in the process of changing your PCP, please notify your insurer before your first visit to one of our physicians. Otherwise, you may be responsible for the full cost of the appointment. Usual and Customary Rates We charge what is usual and customary for services in our area. If your insurance company determines that the cost of your treatment does not meet their definition of “usual and customary,� you may be responsible for the remainder of the payment. 16


IMPORTANT INFORMATION FOR NEW PATIENTS All new patients are asked to complete our Patient Registration form and sign our financial policy before seeing a physician. Please present your insurance card(s) at every visit. All co-payments are expected at the time of service. If you do not have insurance coverage (self-pay accounts), payment is expected at the time of service. Payment plans are accepted with prior approval.  ccounts are due and payable as of the date billed. After 90 days, A accounts with unpaid balances will be considered in default. Returned checks will be assessed a $25 fee for processing.  or your convenience, we accept cash, checks, Visa, MasterCard, F and Discover.

We understand that it may be necessary at times to arrange payment plans for services rendered. If financial problems arise, please contact our Patient Accounts Representative as soon as possible at (207) 303-3300.

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MISSED APPOINTMENTS At New England Cancer Specialists, we work hard to provide the best possible care to you, and all our patients. To achieve this, we need your help: If you are unable to make a scheduled appointment, please call at least two days (48 hours) in advance to cancel or reschedule. Please arrive on time for your appointment.


NewEnglandCancerSpecialists.org

NEW PATIENT INTAKE TEAM 51 U.S. Route 1 (Nonesuch Plaza in Scarborough) 1-833-826-NECS (6327) • F: (207) 303-3234

MAIN OFFICES KENNEBUNK 2 Independence Drive

— SCARBOROUGH 100 Campus Drive, Suite 108

— TOPSHAM 105 Topsham Fair Mall Road

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