NURSE CARE MANAGEMENT SERVICES - Available Tuesdays and Wednesdays

Working directly with you, your family & healthcare provider, the Care Manager can:

· Assist with coordinating your health care needs

o Provide follow up

· Meet with you regarding self-management of your chronic illnesses

o Diabetes, Heart Failure, Heart Disease, COPD, Hypertension, Asthma, Depression, Anxiety, Smoking Cessation, Substance Abuse, High Cholesterol & Obesity

o Help you set Health Related Goals

o Assist you to develop a plan of care to avoid hospital admissions

§ If hospitalization occurs: Assist with transitioning you back home

o Provide education

o Provide medication management and safety

· Facilitate filling out Advanced Care Planning forms

· Identify helpful resources in your community

(From frugalnurse.com)

I’ve posted before about the limitations of Life Line Screening.

The screening tests they offer in their basic “wellness” package are either not recommended at all because they aren’t effective screening tools (carotid ultrasound), or are not recommended for the general public (abdominal aortic aneurysm ultrasound). Please read my previous post for more information on that: Don’t reach for Life Line Screenings

Screening tests are best discussed with your primary care physician. He or she will help you know which tests are right for you—based on your age, health history and family history—as well as how often they should be done.

Only evidence-based screening tests are covered by private health insurance or Medicare without any out-of-pocket cost to you. These tests have received an A or B rating from the United States Preventive Services Task Force (USPSTF), which indicates the benefits of the tests outweigh the harms.

Life Line Screening has you pay upfront for all screening tests. There is no guarantee you will be reimbursed by your insurance company.

For continuity of care, it’s better to have screening tests done at a laboratory or radiology department associated with your physician. Personally, I would not want important screening tests done in a mobile lab or a temporary screening facility set up in a church or gym.

The truth is screening tests are a HUGE money maker. Even some of the worthwhile tests are being done too frequently, or on too many people.

So it’s even worse when a company sells tests we just don’t need.

After my first post, I heard from many readers who were angry about a specific practice by Life Line—hijacking the Medicare Annual Wellness Visit (AWV).

Part of Medicare’s commitment to preventive care is the annual exam. This AWV is paid for in full through Medicare Part B and Medicare Advantage (Part C) plans.

Life Line Screening set up a sister company, Life Line Community Healthcare, to take advantage of Medicare AWVs.

When a person receives an “invitation” from Life Line Screening to take part in a community screening event, they are asked to call and “confirm” the spot being held for them (Spaces are limited, so call now!).

Life Line’s sales people identify themselves as “Preventive Health Advisors (PHA),” although they don’t necessarily have any education in healthcare. Like most telemarketers, their job is not only to get you to buy the advertised product, the wellness package, but also upsell or encourage you to buy more.

By asking for a birth date, the PHA can determine if you are of Medicare age. Then they will ask for your Medicare number to determine if you are eligible (Great news!) for an AWV.

The AWV is performed by a nurse practitioner, and according to the Life Line Community Healthcare website, “…is a comprehensive, one-on-one consultation for seniors with a nurse practitioner to discuss overall health and develop a prevention and wellness plan.” A plan using Life Line’s screening tests, no doubt.

Life Line receives between $100 and $200 for these AWVs. It’s a good business, as Medicare pays them directly.

But it’s not the same as an AWV with your physician. My readers were angry to learn that when they went to their physicians for what they considered their “real” annual exam, Medicare refused payment. Only one AWV is allowed per calendar year, so they were responsible for the entire cost of the second exam.

Related post: Annual exams vs. wellness visits

If you are considering Life Line Screening or Life Line Community Healthcare, please do your homework and be informed.

• Contact your insurance company about whether any of the screening tests are covered by your insurance. A Medicare AWV should NOT cost you anything out of pocket. But if you have a Medicare Advantage plan and see see an out-of-network provider, such as Life Line, you could be responsible for co-pays, deductibles, or more.
• Check out two great evidence-based websites, USPSTF and Choosing Wisely, to find out if any of the screening tests is considered beneficial, and at what age or time interval.
• Beware the upsell. PHAs will ask about your age, health history and family history to scare you into buying more screening tests.
• Don’t give out personal information such as your social security number (your Medicare number) over the phone.
• Read the fine print! If you are scheduled for an AWV, Life Line will have you sign a billing authorization form that gives them permission to bill Medicare on your behalf and receive reimbursement of “authorized benefits.” Also, that you are responsible for any co-pays or deductibles not covered by Medicare.
• Remember you only get one AWV per calendar year. My advice is to save it for your primary care physician.

Life Line Screening and its sister company Life Line Community Healthcare use common marketing and telemarketing techniques to sell their products. We might not like them, we might even think they’re unethical. But aggressive salesmen have been around for as long as we’ve had goods to sell.

However, if you have concerns about any of Life Line’s marketing or screening practices, or feel you’ve been harmed, let someone know.

I suggest contacting one of the following:

• The Better Business Bureau
• Your State Attorney General
• Your State Insurance Commissioner
• The Office of the Inspector General (to report Medicare fraud)

Again, buyer beware.

For the best care at the best price, my advice is to have your annual exam and any screenings tests done by your primary care physician. Contact your insurance company to find out which screening exams are covered.