Preparing for your Visit

Please bring the following items to your appointment:

• A photo ID
• Your health insurance card(s) and referral, if needed
• Your completed Health History Questionnaire
• Any previous genetic test results (of yours)
• Family members’ genetic test results, if applicable
  •  If you are coming in to see us because a family member has already tested positive for a gene mutation, it is very important that you ask them for a copy of their results and bring it with you to your appointment.
  • Even if a family member states that his or her test was “negative”, it is helpful for us to see what that relative was tested for to help us determine whether or not testing is still appropriate for you.
• We may request that you bring copies of pathology reports or other medical records if they are not part of Hunterdon’s Unified Health Record. If there is anything in particular that we would like to review, we will let you know ahead of your appointment.

It’s a good idea to gather some information about your family history prior to your visit with us. We will be asking you about your family members across at least three generations on both sides of the family, including:

• Your children
• Your brothers, sisters, nieces, and nephews
• Your parents, aunts, uncles, and first cousins
• Your grandparents, great aunts, and great uncles

We will be interested in learning about the cancers in your family. For each person who was diagnosed with cancer, it is helpful to know the following information:

• What type of cancer did this person have?
  • If you can provide medical records that document the pathology of the tumor, this information can often be very helpful.
• At what age were they diagnosed with cancer?
• If the person had cancer more than once, or in more than one part of the body, did they have:
  •  A recurrence of their original cancer?
  • Metastatic cancer (cancer that spread to other parts of the body)?
  • Two unrelated cancers?
  • Cancer on both sides of the body in a paired organ (i.e. cancer in both breasts)?
• Did this person ever have genetic testing?
  • If so, please refer to “What do I need to bring to my appointment?”

In addition, we will be interested in learning more about your relatives who have not had cancer. It would be helpful to know as much of the following information as possible:

• The number of men and women in each generation of the family (for example, how many aunts and uncles you have on each side of the family)
• Each relative’s current age
• For deceased relatives, their cause of death and the age at which they passed away
• Any notable medical history, including:
  •  Benign tumors or growths, including colon polyps
    • Specific information about the pathology of the tumor or polyps is incredibly helpful, if available
  • Medical problems that a person was born with
  • Any major surgeries (including hysterectomy)

Please feel welcome to contact us if you have any questions about how to prepare for your appointment.

Absolutely! We welcome you to bring a support person with you to your appointment, whether that person is a spouse, family member, or friend. You may find it helpful to have someone with you to assist with providing family history information or to talk through a decision about genetic testing. We have space in our consultation room to comfortably seat you and two additional people. If you would like to bring more than two support people with you to your appointment, you are welcome to – we just ask that you give us advance notice so that we can arrange for a larger space.

Most patients come in for two appointments, and in general, these appointments last about two hours each.

Please arrive 15 minutes prior to your scheduled appointment time for registration.  If you arrive more than 15 minutes late for your appointment, it is likely that your appointment will need to be rescheduled.  We want to make sure that each patient has access to the full amount of time that the service requires.

You can call your insurance provider directly and ask to speak with someone about your plan’s benefits and coverage. We recommend providing them with a few key pieces of information:

• Do not use the term “genetic testing” or “BRCA testing.” Instead, tell them that the appointment is for “cancer risk assessment.”
• Let them know that the appointment will be an outpatient hospital visit.
• Tell them that the appointment will take place at Hunterdon Medical Center.
• Provide them with examples of typical charges from our program (CPT codes)*
  • 99215 (for non-Medicare insurance) or G0463 (for Medicare)
    (for evaluation and management with the advanced practice nurse)
  • 96040 (for counseling with a trained genetic counselor)
  • 36415 (for drawing blood)

If your insurance requires you to obtain a referral, please complete this before your visit for the evaluation.  Referrals should be made out to Hunterdon Medical Center.

*Please be aware that these CPT codes are the most common charges that patients receive from our program. The charges submitted for each patient depend on a variety of different factors, including the complexity of the evaluation, whether blood is drawn for genetic testing, etc. Therefore, we are not able to provide a definitive list of charges prior to your appointment, and your charges may differ from the ones listed above. This means that it is not possible for us or for your insurance provider to tell you a specific dollar amount that you will need to pay. However, we hope that this information will help you to at least receive general information about your plan’s coverage for this type of service.

During your appointment, your genetic counselor will determine whether genetic testing is medically indicated for you. If it is, the test can most likely be billed to your health insurance. Your genetic counselor will talk with you about the billing process for genetic testing. Most often, the laboratory that performs the genetic testing can investigate your insurance benefits before processing your test and will notify you if your estimated out-of-pocket cost is more than a specific amount. For some patients, genetic testing may be appropriate even though it is not considered medically necessary. If genetic testing cannot be billed to your health insurance, you may choose to pay a reduced out-of-pocket rate for the test. Your genetic counselor can tell you more about this if needed.

Please remember that genetic testing is not always part of the risk assessment process.

No, you do not need to fast for genetic testing bloodwork. Please make sure to eat a healthy meal or snack before your appointment, and feel welcome to bring a beverage with you to stay hydrated.

If for any reason you cannot have blood drawn for genetic testing, please talk with a FRAP staff member about alternative specimen collection options. Some of these may require fasting for at least an hour or two before your appointment.