RECOGNIZED NATIONALLY. TRUSTED LOCALLY. A diagnosis of cancer or a hematology condition can be life-changing. The first of many decisions is where to find the most advanced, innovative, and compassionate medical treatment available. This guide is to provide you with important information about your care at Florida Cancer Specialists & Research Institute (FCS) and to help you navigate through your important healthcare decisions.
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RECOGNIZED NATIONALLY. TRUSTED LOCALLY.
Established in 1984, Florida Cancer Specialists is the largest independent oncology and hematology practice in the United States. Our physicians have trained in such prestigious medical schools and research institutes as Duke, Stanford, UCLA, Harvard, Emory, M.D. Anderson, and Memorial Sloan-Kettering; they provide leadership and consultation in the state’s leading hospitals. Several FCS physicians are also board members of organizations such as the American Society of Clinical Oncology (ASCO), Florida Society of Clinical Oncology (FLASCO) and the Community Oncology Alliance (COA). Florida Cancer Specialists & Research Institute has a well-earned reputation for being a leading community based provider of cancer care services in Florida. We utilize a comprehensive, multidisciplinary approach to cancer treatment and care, combined with some of the most advanced therapies, technologies and clinical trials available today. Our team includes well-respected physicians and highly-trained staff who provide each patient with an individualized treatment plan. FCS is leading the way in cancer research and innovation. Our patients have access to ground-breaking therapies, in a community setting, and may participate in national clinical research studies of drugs and treatment protocols through our partnership with the Sarah Cannon Research Institute. We are one of the largest clinical research organizations in the United States. Often, FCS leads the nation in initiating research studies and offering ground-breaking new therapies to patients. At Florida Cancer Specialists, our primary purpose – and our passion – is to provide the most advanced cancer treatment, using cutting-edge technologies, in a setting where patients can be close to home and surrounded by family and friends. The FCS network of community oncology practices focuses on nationally recognized, evidence-based treatment protocols that offer patients unsurpassed clinical care. Transforming discoveries into clinical practice is just part of what we do. Joining forces with you to ensure optimal health is our life’s work.
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World Class Medicine. Hometown Care.
YOUR EXPERIENCE Whether you have come to FCS for primary treatment or a second opinion, our pledge is to provide the best possible experience and outcome. It’s only natural for you and your family to have questions about your diagnosis and treatment options. At FCS, our goal is to provide as many answers as possible. During your initial office visit, you will have the opportunity for an open conversation with your physician. You will learn about treatment options that are available, what they involve and how our experienced team will support you throughout the process. A nurse practitioner or physician assistant with advanced educational preparation may also be available to work closely with your physician in providing your care. We encourage you to write down all your questions ahead of time and, if possible, bring a friend or family member with you to your office visits. With a second pair of eyes and ears, you’ll be less likely to forget something important. We will work together through the decision-making process to develop personalized plans-of-care that are optimal for patients and families.
WHEN YOU ARRIVE We ask that you arrive on time for your scheduled appointments. Upon arriving for your appointments, please check in with our Patient Service Specialist (PSS) at the front desk. During the check in process, you will be asked to validate your name and date of birth, along with any updates to your insurance or contact information. If you have any changes in your medical history, please be sure to let your nurse or doctor know upon arrival.
SCHEDULING APPOINTMENTS Please call the main office number at your chosen location between 9:00 a.m. and 4:30 p.m., Monday through Friday, and an FCS team member will be pleased to help you. If you need to cancel or reschedule, we ask that you notify us at least 24-hours in advance. A listing of main office numbers can be found on the FCS website at FLCancer.com/Locations. Should you need to reach a physician before 9:00 a.m. or after 4:30 p.m., please contact your office location and the on-call physician answering service will handle your call accordingly.
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TREATMENT OPTIONS At FCS, we practice personalized medicine; each treatment plan is customized for the individual patient. There are many different forms of cancer and multiple treatment options. At FCS, our goal is to provide treatment while helping you to continue your normal life and schedule as much as possible. After determining what your options are, and reviewing both the benefits and risks, you and your doctor will choose a treatment plan that is best for you. Of course, patient reactions to treatment may vary. The best way to prepare is to be informed, so we will address questions about side effects, treatment frequency, and medications. We will also talk about any possible impact on your normal work or life schedule.
CHEMOTHERAPY One of the most common and effective treatments of cancer is the infusion of anti-cancer medications with an intravenous solution, known as chemotherapy or “chemo.” Since every human body is different, administration and results of the infusions are also unique to each patient. Our physicians and nursing staff monitor each patient’s progress, making adjustments as needed to ensure optimal effectiveness. Treatment rooms are designed with your comfort in mind. Each room includes specially designed lounge chairs, and our expert nursing teams provide the highest level of oncological care. At FCS, our model of community-based oncology enables patients to go about their daily lives without lengthy or disruptive travel to receive chemotherapy or other treatments.
ORAL ONCOLYTICS Oral medications are becoming more popular as the treatment of cancer advances. Approximately 35% of all cancer medications are now in a pill form and may be recommended to you as a treatment option. While this treatment option may not require frequent or extended visits to your FCS location since the medication is provided at home, it is imperative that you follow your physician’s orders on dosing frequency and handling instructions. It is recommended that you stay in close contact with your FCS location on any side effects or concerns associated with your ability to take any of these medications. If you are able to fill your prescription through our in-house pharmacy our oncology trained pharmacists will collaborate with your physician and assist in the management of your oral treatment.
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World Class Medicine. Hometown Care.
RADIATION ONCOLOGY FCS has numerous clinical locations, strategically located throughout our network, where patients can receive radiation therapy. Radiation therapy is an important weapon in our battle against cancer. Depending on the type and extent of cancer, radiation therapy can be used alone or in combination with other treatments, such as surgery or chemotherapy. FCS’ radiation oncology department strives to invest and provide in the latest technologies and techniques available. Radiation therapy effectively treats cancer by using high-energy beams of radiation to pinpoint and destroy cancerous cells. Although radiation therapy is similar to an x-ray, the dose of radiation in cancer treatment is much stronger and is given over a longer period of time. Various forms of radiation therapy are available; the two basic types are external beam radiation and internal radiation, or brachytherapy. If your physician determines that radiation therapy should be a part of your treatment plan, and it is not offered within the area where you receive other services, you will be referred to one of our strategic partners for treatment. Your physician will discuss whether radiation therapy is right for you. For more information about radiation therapy, visit our website: FLCancer.com/RadiationOncology.
TARGETED THERAPIES With certain types of cancer, FCS medical oncologists are utilizing targeted therapies, some of the most exciting and promising advances in cancer treatment. Targeted therapies block certain proteins and other pathways that signal cancer cells to grow. These advanced treatments, which are sometimes given in pill form, are designed to destroy cancer cells, leaving healthy cells unharmed. Patients who receive targeted therapies usually do not experience as many of the typical side effects of chemotherapy, such as hair loss and low blood count.
OTHER INFUSIONS FCS has been providing alternative infusion therapy for non-cancer patients since 1984. We partner with both primary and specialty physicians in the communities we serve to offer state-of-the-art infusion therapy for non-cancer patients. Under the supervision of our board certified physicians, we have dedicated teams of registered nurses and pharmacy technicians who specialize in personalized care when administering these types of medications.
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CLINICAL TRIALS PROVIDE NEW T REATMENT OPTIONS On the leading edge of clinical trial research, Florida Cancer Specialists offers patients extensive access to national trials and more options for advances in treatment. CLINICAL RESEARCH One of the greatest advantages for our patients and our practice is the opportunity to benefit from ongoing medical research through clinical trials. Clinical trials are studies that evaluate the effectiveness of drugs or treatment routines. Participants may receive promising new treatments, and if the trial is successful, participants are the first to benefit. In association with the Sarah Cannon Research Institute, one of the largest and most respected clinical trial organizations in the United States, Florida Cancer Specialists & Research Institute has participated for many years in numerous clinical research studies involving investigational drugs, treatment methods and therapy combinations. FCS physicians and staff are extremely proud of their endeavors to bring the latest clinical studies and results of research to our patients in the search for better cancer treatment and, eventually, more cures. Patients seeking the most advanced cancer care available no longer have to travel to large academic institutions. With many active trials underway, FCS is investigating new treatments for all types of cancer, including breast, lung, melanoma, multiple myeloma, ovarian and prostate cancers. Rapid advances in targeted therapies and molecular biology are leading to new drug innovations that are revolutionizing the field of oncology. Through its dedication to working on ground-breaking research, FCS is committed to being a part of these discoveries. More detailed information related to FCS’ clinical trails can be found on the web at FLCancer.com/ClinicalTrials. While there is no guarantee that any treatment will be successful, clinical trials give patients the opportunity to participate in approved and exploratory therapies without long distance travel. Talk to your doctor to discuss whether a clinical trial might be right for you and to learn about your options. Recognized by the American Society of Clinical Oncology (ASCO) with a national Clinical Trials Participation Award
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World Class Medicine. Hometown Care.
PHASE 1 TRIALS PROGRAM
Clinical trial leader in nearly 80% of approved cancer therapies over the last 10 years
DRUG DEVELOPMENT UNIT (DDU) As a strategic research site for Sarah Cannon Research Institute, Florida Cancer Specialists conducts clinical trials research at more than 30 locations throughout the state, including at our Drug Development Unit (DDU), which is dedicated exclusively to Phase I Clinical Trials. FCS is one of only a handful of community practices in the nation to offer this level of clinical research. Since the DDU was established in 2011, the Phase 1 Trials program at FCS has grown exponentially to become one of the leading clinical research programs in the nation. In 2015, over 180 patients were enrolled in over 40 first-in-human trials, rivaling some academic medical centers. Detailed clinical trial information is available at: FLCancer.com/TrialNavigator.
Years of advancing science through clinical research
Approximately patients enrolled in clinical trials per year
first-in-human clinical trials| comducted for promising new therapies
active clinical trials per year
We are also indebted to Angel Flight™ Southeast, Inc., a non-profit volunteer pilot organization that arranges free air transportation by private aircraft for FCS patients, living all over Florida, who qualify for a Phase I clinical trial. Volunteer pilots fly patients to receive treatment in our Sarasota location and then return the patient to his/her home.
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TIPS FOR CHEMOTHERAPY
CHEMOTHERAPY INFUSION SERVICES Chemotherapy simply means the use of infused medications to fight cancer. The medicine, either infused over an extended period of time, or provided via a short injection, works by killing cancer cells. Some of the chemotherapy medications only target and kill cancer cells, but some chemotherapy may also affect normal cells. As a result of the medication affecting your normal cells, this causes some common treatment side effects. While not all patients experience the same side effects to chemotherapy, the most common side effects are nausea, hair loss, blood count changes, fever, digestive interruptions, neuropathy, and changes in appetite. Our clinical team will cover any potential side effects that will be anticipated if you elect to receive chemotherapy. At FCS, world-class physicians have extensive experience in treating all types of cancer. New, more effective medications are available to be used alone or in combination with other drugs and treatment modalities to target your specific cancer.
WHAT TO BRING TO YOUR TREATMENT Some suggestions for optimum comfort:
you can also bring a sandwich, favorite snack or beverage in case your treatment lasts longer than expected. Please remember that foods with strong odors may be unsettling to others receiving treatment. Your Favorite Music, Headphones or Electronic Device – Many patients enjoy listening to their favorite music during treatment. We encourage you to bring headphones, a laptop, iPad® or any other electronic device as complimentary Wi-Fi is accessible at all of our office locations. In addition, some locations offer iPads® or individual DVD players that may be used by patients during chemotherapy. Most locations are also equipped with televisions. Magazines, Books & Games – You are welcome to borrow reading material from our large selection of donated books. We gratefully accept books, magazines and games that you may wish to donate to our library for others to enjoy.
PATIENT EDUCATION FCS believes that well-informed patients have more positive attitudes and are less apprehensive. We provide pre-treatment patient education classes that focus on three goals:
Warmth & Relaxation – Be sure to wear clothing that is comfortable and doesn’t bind. Many patients find that bringing a sweater, favorite blanket, a pair of socks or even a hat not only keeps them from feeling chilly, but also provides the comfort of something familiar from home. Snacks & Beverages – Light snacks and juice may be available, and
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World Class Medicine. Hometown Care.
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Giving you practical information to ensure smooth and comfortable treatment sessions
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Teaching you about typical side effects and preparing you to deal with them
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Helping you know when your symptoms are typical side effects and when you should seek immediate medical attention
We also provide information about how to handle ongoing questions, what to bring with you to treatments, and who to contact in an emergency. This educational session will be of significant benefit to you and your family.
OTHER CONSIDERATIONS Make arrangements for a ride home in advance – Check with your physician or nurse about the type of infusion treatment you will be receiving. Many of the pre-medications can make you sleepy. If you are receiving one of these medications, make sure someone is available to drive you home. Fragrances – Many patients receiving chemotherapy may experience extreme sensitivity to fragrances. In an effort to accommodate those who are chemically sensitive to certain fragrances and other scented products, please refrain from using perfumes and scented lotions on the day(s) you come into the office for treatment. All guests of patients should adhere to this consideration as well. Cell phones – During your visit for infusion services we kindly ask you to limit your use of cell phones for phone calls.
ROLE OF PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS
Bring all medications you are scheduled to take – We suggest you put together a travel bag/container to bring your daily medications– including those for pain–with you for chemo sessions.
Most FCS centers have Physician Assistants (PA) or Nurse Practitioners (ARNP) that assist in your healthcare under the supervision of your FCS oncologist. These licensed individuals are all nationally certified and state licensed to practice medicine under the supervision and in collaboration of a physician. They will play a critical role in your treatment planning, monitoring, and recovery. The PA or ARNP has the capacity to perform examinations and procedures, order treatments, diagnose diseases, prescribe medication, order and interpret diagnostic testing, and make applicable referrals.
Guests – Each patient is allowed to bring one guest to their infusion appointment. Guests may be asked to leave the treatment room if space for patients becomes an issue. For the safety of patients and children alike, we respectfully request that you do not bring young children with you to treatment.
MANAGING SIDE EFFECTS Nausea – While nausea is one of the most common side effects to chemotherapy treatment, there are many options to help prevent and offset this uncomfortable result associated with your treatment. You may receive a “premedication” or a pill that will help manage your nausea. Please consult your oncologist or nurse on various options to stay comfortable during your treatment. Hair loss – Many chemotherapy treatments cause hair loss. Since the medication is attacking cells, sometimes they will also kill the cells that promote hair growth. The loss of hair is almost always temporary and hair growth will resume upon completion of your therapy. If hair loss is expected, this will be a discussion with you during your patient education session with an oncology nurse that will also provide information on the duration of this side effect. Fever – A fever can be a serious concern when undergoing chemotherapy. You may be asked to closely monitor your temperature and contact your FCS location upon immediate recognition of an elevated body temperature. For more information on how to manage side effects, please discuss your symptoms with your oncologist and visit the online resources at: www.FLCancer.com/CommonSideEffects.
For more information about Physician Assistants and Nurse Practitioners, visit: FLCancer.com/ClinicalSupport.
ROLE OF ONCOLOGY NURSES FCS outpatient chemotherapy infusion centers are located at each of our offices and are designed with your comfort in mind. We staff our centers with highly qualified oncology nurses who work closely with our physicians in the management of chemotherapy treatments and monitoring of patients’ physical and emotional well-being. Oncology nurses have specialized knowledge and experience that enables them to provide the highest quality care to patients undergoing complex cancer treatments such as chemotherapy. In addition, these dedicated and trusted professionals are a source of education and support to patients and families who can advise on self-care during treatments to prevent complications and decrease side effects. Knowing what to expect helps relieve apprehension. We encourage you to ask questions and discuss any concerns with the staff.
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D IAGNOSTIC S ERVICES
LAB SERVICES Each FCS location provides COLA (Clinical Outpatient Laboratory Accreditation) accredited, state and federally licensed in-house laboratories for all routine blood work. We perform all standard blood work on site with other laboratory tests performed at our central lab facility, including chemistries, tumor markers and a variety of other diagnostic tests, located in Ft. Myers, FL. Blood collection and lab analysis services are performed at your FCS location during your visit for your convenience. All laboratory tests performed in-house are usually available within our electronic medical record within 24 hours to optimize clinical care.
PATHOLOGY SERVICES The FCS Pathology Lab located in Ft. Myers, FL, is a state-ofthe-art facility that is comprised of three specialties: Histology, Flow Cytometry, and fluorescent in situ hybridization (FISH). Our FCS Pathology Lab and team of highly trained pathologists and lab technicians are able to provide both the technical analysis and the professional evaluation of all aspects of a comprehensive hematopathology report; this includes histology/morphology, immunohistochemistry (IHC), in situ hybridization (ISH), flow cytometry, fluorescent in situ hybridization (FISH), cytogenetics,
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PAM50, and polymerase chain reaction (PCR). FCS specifically performs the flow cytometry, histology/morphology, IHC, ISH, FISH, and PNH (paroxysmal nocturnal hemoglobinuria) testing. The purpose of the pathology laboratory is to determine if a malignancy (cancer tumor) is present and if so, what type of malignancy is present. These pathology tests also assist your physician determine the treatment to best suite your individual case. Additionally, FCS pathologists are in frequent contact with your oncologist, facilitating the expedited reporting of clinically important information, which results in faster and more personalized patient care. FCS strives to provide you with the latest diagnostic services so our list of available pathology and laboratory testing is constantly evolving as the latest cutting edge advancements are made available to the public. All FCS pathology services are accredited by the College of American Pathologists (CAP), an internationally renowned program that recognizes laboratories that go well beyond regulatory compliance in achieving the highest standards of excellence to positively impact patient care and safety.
World Class Medicine. Hometown Care.
DIAGNOSTIC IMAGING SERVICES FCS provides advanced diagnostic imaging, accredited by the American College of Radiology, at many of our locations. Diagnostic imaging provides a visual display of organs or tissues that assist physicians in making treatment decisions. At many FCS locations, we provide Computed Tomography (CT) scans, which use x-rays to create cross-sectional images of the body, and Positron Emission Tomography (PET) scans, which utilize nuclear medicine imaging. These tests are used to accurately diagnose and identify the stage of cancer, determine optimum treatment plan, and assess response to treatment. FCS is dedicated to ensuring that our patients have access to the most advanced technologies that are available. In addition to the American College of Radiology accreditation, our scanners have the latest technologies to modify and track radiation doses per scan to ensure maximum patient safety. Diagnostic imaging is an important aspect of cancer diagnosis and treatment. Advanced technology and a dedicated radiology team to interpret results are critical components in your cancer care. In addition to cutting-edge technology and services, FCS offers utmost convenience in scheduling your diagnostic tests at multiple locations to best meet your schedule.
SEE YOUR CHART See Your Chart offers simple and convenient online access to your personal health record at any time from any location with Internet access. By signing into your secure personal account, you can: •
Review and keep track of doctor’s appointments, test results, and other important medical information
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View test results from your lab, pathology, and radiology reports
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Receive education and support from an online community
See Your Chart is especially helpful in keeping extended family members informed about your treatment – plus, you can log in from any computer or mobile device 24/7. With this first-of-itskind online tool, connecting to your personal health information is now easier than ever.
ELECTRONIC MEDICAL RECORDS (EMR) Our Electronic Medical Records system houses the details of your medical history, treatment plan, medications, lab results and more. This puts your entire medical team, local and remote, on the same page, with regard to your treatment plan and case history. The EMR enables your medical team to have access to your records 24 hours a day, 7 days a week to provide optimum care. Additionally, we offer a physician portal that connects all of your doctors to ensure that you receive coordinated care.
Rx to Go is a specialty oral oncology pharmacy located in Ft. Myers, FL. Rx to Go specializes in delivering oral chemotherapy and other specialty medications to our patients throughout the state of Florida and the United States. Approximately 35% of all cancer drugs are available in pill form, including the newer targeted therapies. Although oral medications offer more convenience for patients, it is critical that these drugs be filled and delivered on a timely schedule and that patients are closely monitored to ensure compliance in taking their medications.
Rx to Go Advantages Since Rx to Go is a part of the Florida Cancer Specialists network, there are several advantages for patients: •
Oncology Pharmacists have real-time access to patient records and your physicians, so they are able to provide faster, superior service and guidance to assist you in understanding your medications
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Oral cancer drugs are in stock and available to fill your prescription immediately
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Medications can be delivered to patients’ homes in Florida and other states
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Rx to Go Specialists are trained to provide assistance with insurance qualifications and co-pays, making it easier to navigate paperwork and meet insurance requirements
So, no matter where you live, if you are an FCS patient and you have been prescribed an oral cancer medication, you can sign up for Rx to Go and experience excellent support from our in-house pharmacy. For more information, visit FLCancer.com/RxtoGoService.
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OTHER SERVICES & RESOURCES
What is Integrative Therapy?
ONLINE RESOURCES Our website, FLCancer.com, provides information about treatments, clinical trials, nutrition, health and wellness tips, making online payments and more. You will also find an online glossary of terms, video profiles of our physicians and several educational videos about FCS services and resources.
Integrative Therapy is a total approach to care that involves both the patient’s mental and physical well-being. It combines traditional medical care with services such as nutritional education, oncology massage, acupuncture or yoga that help patients better cope with the stress and side effects of cancer treatment.
Why Do People Use Integrative Therapy?
INTEGRATIVE ONCOLOGY PROGRAM At Florida Cancer Specialists, our focus extends beyond traditional approaches in order to strengthen the mind and body alike. Our approach to wellness and integrative care is to provide the safest evidence-based options, education, and resources available to our patients. In addition to comprehensive treatment plans, many of our locations offer integrative therapies that combine standard medical care, based on scientific evidence such as chemotherapy, radiation and surgery, with the wellness practices and services that have proven to be most promising in helping patients cope with the side effects of cancer treatment. Services vary by location, so please consult your physician about what is available in your treatment center.
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To help cope with the side effects that comes along with treatment, such as nausea, pain and fatigue
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To build up energy through positive thinking
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To comfort and ease the concerns often associated with the treatment of cancer and other related stress
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To include the mind, body and spirit throughout the healing process
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To take an active role in their own care
If you are interested in integrative therapies, consult your physician. Our physicians encourage patients to take an active role in their own care. Talking with your doctor will assure that all aspects of your cancer treatment work together to provide the best outcome.
World Class Medicine. Hometown Care.
MEANINGFUL SUPPORT FOR CANCER PATIENTS The last thing patients undergoing treatment want to worry about is paying their bills. The Florida Cancer Specialists Foundation helps to relieve some of the financial stress, so patients can concentrate on their treatment and obtain the best possible outcome.
The FCS Foundation is a 501(c)(3) non-profit organization that assists qualifying FCS cancer patients with non-medical living expenses while they are undergoing treatment. “When I learned about
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help that I needed.”
— Marilyn Austin FCS Foundation Recipient
— Romano Moglia FCS Foundation Recipient
Apply for Help
Types of Assistance
Ways to Donate
In order to be eligible to receive financial assistance from the FCS Foundation, patients must:
The FCS Foundation strives to relieve qualified patients of financial stress, so patients can focus on what really matters—fighting cancer. Examples of day-to-day living expenses for which patients can apply for assistance:
The FCS Foundation accepts financial donations of stocks, bequests, memorial gifts and honorariums. Your gift is always deeply appreciated.
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Be actively undergoing cancer treatment Meet certain financial income requirements (provide paycheck stubs, SSDI letter or other proof )
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Rent or mortgage payments
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Include all who are living at your residence on household income
Utility payments (water, sewer, electric)
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Complete application for assistance
Telephone payments (landline or mobile)
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Transportation costs (car payments or insurance)
Mail checks to: FCS Foundation 5202 Paylor Lane Sarasota, FL 34240 Donate by phone: 941-677-7181 Donate online: Foundation.FLCancer.com
The Foundation does not pay patient medical bills, co-payments, or credit card bills of any kind, and does not provide direct patient cash grants.
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INSURANCE & FINANCIAL SERVICES for the care provided by FCS. In accordance with your insurance guidelines, we collect any co-payment, deductible, or co-insurance amounts at the time of service. A Financial Counselor will meet with you during your visit to review your insurance benefits, financial obligations, and they will be able to assist you with any questions you may have regarding your account at any time while in the office. If your insurance plan provides for direct reimbursement to our office, we are happy to file insurance claims on your behalf. We will make our best efforts to ensure that we have appropriately estimated your out of pocket responsibility the first time; however, your insurance Explanation of Benefits (EOB) will be the final determination of your out of pocket responsibility.
Medicare Physician Quality Reporting (PQRS) FCS participates in Medicare’s Physician Quality Reporting System (formally PQRI). This Medicare initiative requires FCS to report specific quality metrics related to your care. This will not be an additional cost to you. For more detailed information about this Medicare initiative, visit www.cms.gov or by phone at 1-866-2888912. TTY users should call 1-877-715-6222.
Limited Nurse Visits
INSURANCE & FINANCIAL SERVICES FCS is committed to being a supportive resource for our patients. All FCS offices have a dedicated Financial Counselor that will be your point of contact for any insurance related questions while you are in the office. Additionally, FCS has a centralized business office in Ft. Myers, FL that will verify your insurance coverage, obtain authorizations, file your insurance claims, and work with your insurance company. Our central business office can be contacted at 1-877-327-2228 should any issues arise related to your insurance.
Patient Assistance If you are concerned about your ability to make a payment or have financial questions about your out of pocket expenses, our Financial Counselors are available at every FCS location to help you determine the scope of your insurance coverage, discuss options for payments, and provide information regarding various foundations and funding that might be available. You may also contact our Patient Assistance Department at 1-877-327-2228 to review any potential funding options for your care.
Financial Policies For your convenience, we will verify your insurance eligibility and benefits at the time of service or in advance of your appointment. The insurance carrier will inform us of your financial responsibility
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During your visits to FCS, you may meet with a nurse who will evaluate your condition on behalf of the physician in order to provide you with the best care. Please be aware that your insurance plan may institute a financial responsibility when this charge is billed. It will be your responsibility to pay for any charges applied by your insurance company.
Diagnostic Testing As part of your care at FCS your physician may order additional diagnostic testing that will assist in monitoring your health. Please be aware that your insurance plan may institute a financial responsibility when charges are billed for diagnostic testing, whether through a non-FCS diagnostic partner or FCS’ diagnostic services. Any information about the type of tests your physician is ordering can be discussed with your physician.
Waivers During your visit with your physician, you may make a choice to undergo a treatment that may not be covered by your insurance. If this situation occurs, a Financial Counselor will discuss this with you in advance of your treatment to review your options. In accordance with insurance guidelines, you will be asked to sign a waiver so FCS has written consent of your decision. A waiver is not required for all treatment choices and your Financial Counselor will go over this in detail if your situation requires a waiver.
World Class Medicine. Hometown Care.
GLOSSARY OF TERMS Acute – Refers to symptoms that start and worsen quickly but do not last over a long time. Antibody – An antigen-specific receptor, also called an immunoglobulin, made by B-lymphocytes. Antibodies are a critical component of the immune system that circulate in the blood and bind to foreign antigens and tumor cells, marking them for destruction by immune cells. Antiemetic – Also known as anti–nausea medication, an antiemetic is a drug that relieves nausea and vomiting. Benign – “Benign” indicates a non– cancerous condition, tumor or growth that does not spread to other parts of the body, nor change or destroy nearby tissue. Biopsy – Removal of a small tissue sample from an organ or other part of the body to determine the presence of disease.. Bone marrow – The soft, spongy tissue found in the center of large bones where blood cells are formed. Cancer – Cancer occurs when cells in a particular part of the body begin to grow out of control. Cancer cells, also called malignant cells, can invade other tissues and form new tumors. Cells – The basic units that make up the human body. Complete Blood Count (CBC) – A test that measures the number of white blood cells, red blood cells and platelets, as well as the fraction of the blood composed of red blood cells and the total amount of hemoglobin in the blood. CT Scan – A series of detailed pictures of areas inside the body taken from different angles. The pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography scan, computerized axial tomography scan, and computerized tomography. Grade – A classification system that indicates how aggressive a tumor may be. Most pathologists assign a grade from 1 to
4 based on how the cancerous cells look compared to normal cells. Hematocrit (HCT) – A blood test that measures the percentage of red blood cells found in blood. Infusion – A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. Jaundice – A yellowish staining of the skin and sclerae (the whites of the eyes) that is caused by high levels in blood of the chemical bilirubin. Jaundice can signal problems in the blood, liver and bile ducts or indicate the presence of an infection. Laboratory test – A procedure that evaluates a sample of blood, urine, or other substance from the body to make a diagnosis, plan treatment, check whether treatment is working, or observe a disease over time. Lymph Nodes – Lymph nodes are found throughout the body including the neck, underarms and groin. Lymph nodes assist the immune system by catching viruses, bacteria and other unknown materials. Malignant - An abnormal growth of cells that are cancer. Mass – A lump in the body. Metastasis – The spreading of cancer cells from one area of the body to surrounding tissues or organs. After cancer cells spread to other parts of the body, they continue to multiply and form new tumors. Neoplasm – An abnormal growth of cells that may or may not be cancer (malignant of benign). Neutropenia – An abnormally low count of white blood cells. Neutropenia may be caused by the following: congenital disorders, autoimmune disorders, cancer, viral infections, and certain drugs.
Pathology – The branch of medicine that deals with the laboratory examination of body tissue samples for diagnostic or forensic purposes. PET Scan – A procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is taken up. Because cancer cells often take up more glucose than normal cells, the pictures can be used to find cancer cells. Prognosis – Chance of recovery; a prediction of the outcome of a disease. Ask your physician more about survival statistics used to estimate a patient’s prognosis. Red Blood Cell – Produced in the bone marrow, red blood cells (RBCs) contain hemoglobin which permits them to carry oxygen to organs in the body. Transfusion – A safe procedure in which red blood cells or platelets are administered through an intravenous line. Transfusions replace blood or platelets lost during surgery, chemotherapy or due to blood disorders. Tumor – A mass formed when normal cells begin to change and grow uncontrollably. A tumor can be benign (noncancerous) or malignant (cancerous, meaning it can spread to other parts of the body). It can also be called a nodule or mass. White Blood Cell – White blood cells, or leukocytes, fight infection in the body.
Definitions for additional terminology related to cancer can be found online at: FLCancer.com/Glossary
Oncologist – A doctor who specializes in treating people with cancer. The five main types of oncologists are medical, surgical, radiation, gynecologic, and pediatric oncologists.
FLCancer.com
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THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY! Florida Cancer Specialists and Research Institute (“Florida Cancer Specialists”) is committed to protecting the privacy and security of our patients’ confidential health information. We are required by law to maintain the privacy of your health information and provide you with this Notice of Privacy Practices of our legal duties and privacy practices regarding your health information. Florida Cancer Specialists will abide by the terms in this Notice. HOW WE MAY USE YOUR HEALTH INFORMATION We may use and disclose your health information for the following: Treatment: We may use your health information to treat you and provide health care services. Examples of uses of your health information for treatment purposes are: • Information obtained by a nurse, physician, or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you. • Your physician will document in your record his or her expectations for the members of your health care team. Members of your health care team will then record the actions they took and their observations. In that way, the physician will know how you are responding to treatment. • We will also provide your subsequent health care provider(s) with copies of various reports that should assist him or her in treating you. Appointment Reminders: We may use and disclose your health information to contact you as a reminder that you have an appointment for treatment or medical care at Florida Cancer Specialists or another entity/health care provider for whom we schedule services. Payment Purposes: We may use and disclose your health information to bill for your health care services in accordance with state law. We submit requests for payment to your health insurance company or other appropriate payer. The payer (or other business associate helping us obtain payment) requests information from us regarding medical care given. We will provide information to them about you and the care given. Health Care Operations: We obtain services from our insurers or other business associates such as quality assessment, quality improvement, outcome evaluation, protocol and clinical guideline development, training programs, credentialing, medical review, legal services, and insurance. We will share information about you with such insurers or other business associates as necessary to obtain these services. YOUR HEALTH INFORMATION RIGHTS The health and billing records we maintain are the physical property of the practice. The information in it, however, belongs to you. You have a right to: • Request a restriction on certain uses and disclosures of your health information by delivering the request to our practice. Although we are not required to grant the request, we will comply with a request that is granted and we are required to agree to your request not to disclose information to a Health Plan regarding items or services that you have paid for in full out-of-pocket; • Obtain a paper copy of the current Notice of Privacy Practices (“Notice”) by making a request at our practice; • Request that you be allowed to inspect and copy your health record and billing record—you may exercise this right by delivering the request to our practice. Under certain circumstances, your request may be denied. If your request is denied, you will be informed of the reason for the denial and a copy will be provided to a representative designated by you. You will have an opportunity to appeal a denial of access to your protected health information, except in certain circumstances; • Request an electronic copy of your medical record at the costs of labor and a reasonable cost-based fee for any electronic media we provide at your request in producing the electronic copy; • Request that your health care record be amended to correct incomplete or incorrect information by delivering a request to our practice. We may deny your request if you ask us to amend information that: • Was not created by us, unless the person or entity that created the information is no longer available to make the amendment; • Is not part of the health information kept by or for the practice; • Is not part of the information that you would be permitted to inspect and copy; or, • Is accurate and complete. If your request is denied, you will be informed of the reason for the denial and will have an opportunity to submit a statement of disagreement to be maintained with your records; • Request that communication of your health information be made by alternative means or at an alternative location by delivering the request in writing to our practice; • Obtain an accounting of disclosures of your health information as required to be maintained by law by delivering a request to our practice. An accounting will not include uses and disclosures of
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information for treatment, payment, or operations unless your records are maintained electronically. The accounting will also not include disclosures or uses made to you or made at your request; uses or disclosures made pursuant to an authorization signed by you; uses or disclosures made in a facility directory or to family members or friends relevant to that person’s involvement in your care or in payment for such care; or, uses or disclosures to notify family or others responsible for your care of your location, condition, or your death. • We are generally not permitted to use or disclose your protected health information for marketing purposes or to sell your protected health information without your written authorization. • Revoke authorizations that you made previously to use or disclose information by delivering a written revocation to our practice, except to the extent information or action has already been taken. If you want to exercise any of the above rights, please contact the practice’s Privacy Officer: 4371 Veronica S. Shoemaker Blvd., Fort Myers, FL 33916; 239-274-8200; in person or in writing, during regular business hours. [S]he will inform you of the steps that need to be taken to exercise your rights. OUR RESPONSIBILITIES The practice is required to: • Maintain the privacy of your health information as required by law; • Provide you with a notice as to our duties and privacy practices as to the information we collect and maintain about you; • Abide by the terms of this Notice; • Notify you if we cannot accommodate a requested restriction or request; and, • Accommodate your reasonable requests regarding methods to communicate health information with you. • Notify you of a breach in your unsecured protected health information. We reserve the right to amend, change, or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding the protected health information we maintain. If our information practices change, we will amend our Notice. You are entitled to receive a revised copy of the Notice by calling and requesting a copy of our “Notice” or by visiting any of Florida Cancer Specialists office locations and picking up a copy. TO REQUEST INFORMATION OR FILE A COMPLAINT If you have questions, would like additional information, or want to report a problem regarding the handling of your information, you may contact the practice’s Privacy Officer at 239-274-8200. Additionally, if you believe your privacy rights have been violated, you may also file a complaint with the U.S. Department of Health & Human Services Office for Civil Rights by sending a letter to 200 Independence Ave., S.W. Washington, D.C. 20201, calling 1-877-696-6775, or visit: hhs.gov/ocr/privacy/hipaa/complaints/ • We cannot, and will not, require you to waive the right to file a complaint with the Secretary of Health and Human Services (HHS) as a condition of receiving treatment from the practice. • We cannot, and will not, retaliate against you for filing a complaint with the Secretary of Health and Human Services. OTHER USES AND DISCLOSURES Florida Cancer Specialists may use and disclose your health information for the following: Communication with Family • Using our best judgment, we may disclose to a family member, other relative, close personal friend, or any other person you identify, health information relevant to that person’s involvement in your care or in payment for such care if you do not object or in an emergency. Notification • Unless you object, we may use or disclose your protected health information to notify, or assist in notifying, a family member, personal representative, or other person responsible for your care, about your location, and about your general condition, or your death. Research • We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information. Disaster Relief • We may use and disclose your protected health information to assist in disaster relief efforts. Organ Procurement Organizations • Consistent with applicable law, we may disclose your protected health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant. Food and Drug Administration (FDA) • We may disclose to the FDA your protected health information
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relating to adverse events with respect to food, supplements, products and product defects, or post-marketing surveillance information to enable product recalls, repairs, or replacements. Workers Compensation • If you are seeking compensation through Workers Compensation, we may disclose your protected health information to the extent necessary to comply with laws relating to Workers Compensation. Public Health • As authorized by law, we may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability; to report reactions to medications or problems with products; to notify people of recalls; to notify a person who may have been exposed to a disease or who is at risk for contracting or spreading a disease or condition. Abuse & Neglect • We may disclose your protected health information to public authorities as allowed by law to report abuse or neglect. Employers • We may release health information about you to your employer if we provide health care services to you at the request of your employer, and the health care services are provided either to conduct an evaluation relating to medical surveillance of the workplace or to evaluate whether you have a work-related illness or injury. In such circumstances, we will give you written notice of such release of information to your employer. Any other disclosures to your employer will be made only if you execute a specific authorization for the release of that information to your employer. Correctional Institutions • If you are an inmate of a correctional institution, we may disclose to the institution or its agents the protected health information necessary for your health and the health and safety of other individuals. Law Enforcement • We may disclose your protected health information for law enforcement purposes as required by law, such as when required by a court order, or in cases involving felony prosecution, or to the extent an individual is in the custody of law enforcement. Health Oversight • Federal law allows us to release your protected health information to appropriate health oversight agencies or for health oversight activities. Judicial/Administrative Proceedings • We may disclose your protected health information in the course of any judicial or administrative proceeding as allowed or required by law, with your authorization, or as directed by a proper court order. Serious Threat • To avert a serious threat to health or safety, we may disclose your protected health information consistent with applicable law to prevent or lessen a serious, imminent threat to the health or safety of a person or the public. For Specialized Governmental Functions • We may disclose your protected health information for specialized government functions as authorized by law such as to Armed Forces personnel, for national security purposes, or to public assistance program personnel. Coroners, Medical Examiners, and Funeral Directors • We may release health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release health information about patients to funeral directors as necessary for them to carry out their duties. Health Information Exchange/Regional Health Information Organization • We participate in a health information exchange (HIE) or regional health information organization (RHIO) to share your health information with other providers in the HIE or RHIO who provide health care to you. If you do not want your health information to be made available through the HIE or RHIO, you may opt out by submitting a written request to the Privacy Officer. You may opt back in to the HIE or RHIO at any time. You do not have to participate in the HIE or RHIO to receive care. Other Uses • Other uses and disclosures, besides those identified in this Notice, will be made only as otherwise required by law or with your written authorization and you may revoke the authorization as previously provided in this Notice under “Your Health Information Rights.” Website • Florida Cancer Specialists’ Notice of Privacy Practices is available on the website at: FLCancer.com/forms/privacy_notice.9.23.2013.pdf
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