CALL US: Holly Springs: 919-363-8666 West Cary: 919-261-6446 Evening, Weekend & Same day Appointments Available! Sick walk-ins welcome!

Tricity Family Medicine: Services

Services

Depression
Diabetes Management
Thyroid disease
Depression or Anxiety
Back Pain
High blood pressure
High cholesterol
Heart disease and circulation problems

Foreign body removal
Rashes and dry skin
Stomach pain and upset
Diarrhea and constipation
Shortness of breath and cough
Heart Burn
Urinary Tract Infection ( UTI)
IUD ( Intrauterine device) Removal

Allergies & Sinus problems
Cold, Sore throat, Fever
Headaches
Ear lavage
Dizziness
Thyroid disease

Helpful Websites

Centers for Disease Control and Prevention –http://www.cdc.gov

Familydoctor.org – http://familydoctor.org/familydoctor/en.html

HealthyWomen – http://www.healthywomen.org/

Healthy Men – http://www.ahrq.gov/patients-consumers/patient-involvement/healthy-men/index.html

American Academy of Pediatrics – http://www.healthychildren.org

This comprehensive site from the American Academy of Pediatrics for parenting kids from prenatal until adulthood covers diseases, staying healthy, mental and social concerns, school problems, and safety. Parents of prospective and new teen drivers will appreciate the site’s Teen Driving Agreement.

SuperKids Nutrition – http://www.superkidsnutrition.com/

SuperKids Nutrition was founded by a registered dietician to promote good nutrition; it offers health information for parents, kids and health educators through a blog, activities and links to even more online resources. For parents, there are tips and toolkits to promote healthy living in the family. For kids, an animated SuperKids Crew teaches about nutrition, and there are fun activities to print and complete.

Teen Health – http://www.nlm.nih.gov/medlineplus/teenhealth.html

This MedlinePlus page was created for teens and parents. There are links to information on nutrition, emotions, body image, alcohol, drugs, sexuality, and other topics of interest to adolescents.

Academy of Nutrition and Dietetics–Eatright.org – http://www.eatright.org/
The Academy of Nutrition and Dietetics is the best source of accurate, credible and timely food and nutrition information for the public. The website includes information on nutrition throughout the lifecycle, advice for achieving and maintaining a healthy weight, information on prevention and management of diseases, and a searchable database of registered dietitian nutritionists.
Weight loss website – www.sparkpeople.com

It’s an online dieting community, but SparkPeople.com also places a huge emphasis on adopting a healthy lifestyle for long-term weight maintenance. The site is packed with useful tools and resources for you to explore. The fitness, recipe, and cooking videos are all easy to follow, and the motivational quizzes and success stories help to keep you on target with your goals.

Weight loss website –www.Calorie-Count.com

Calorie-Count.com lets you log your food intake and workouts, but also offers great tips for beginner exercisers and expert dieting advice. In addition, there’s a mobile-friendly version of the site so you can stay on top of recording what you’ve eaten even on the go.

Weight loss website – www.MyFitnessPal.com

MyFitnessPal.com Logs has easy-to-understand charts for tracking your progress and also shows you a count of how many calories you have “left” to consume for the day to keep you on track with your goals.

The AGS Foundation for Health in Aging – http://www.healthinaging.org

Health In Aging provides up-to-date information on healthcare and aging for older adults, caregivers, and providers. The site provides information and tip sheets on common health topics and resources to help find and communicate with geriatrics healthcare providers. Information is easy to understand and available in English only. The site was created by the American Geriatrics Society’s Health in Aging Foundation and is overseen by elder care experts.

Benefits Checkup – https://www.benefitscheckup.org/

Benefits Checkup is a service aimed at helping older adults finds state, federal and private benefits programs to help pay for prescriptions, healthcare, food, and other services. Older adults can answer a series of questions and receive information and applications for programs for which they may be eligible. The site also contains links to forms and resources for local and national programs. Information is in English, although many forms are available in multiple languages. The site is a service of National Council on Aging, a non-profit and advocacy organization for older adults.

Eldercare Locator – http://www.eldercare.gov/

Eldercare Locator, service of the U. S. Administration on Aging, connects older adults and caregivers to services for seniors. The online search function provides lists of trusted local resources, organizations, and services. There are also factsheets and links to online information about medicine and health, advanced care planning, and other issues. A hotline and online chat connects to Eldercare information specialists who can answer detailed questions. Online information is available in English; information in other languages is available by phone.

The Family Caregiver Alliance – http://www.caregiver.org

Family Caregiver Alliance (FCA) provides information, services, and support for caregivers and families of persons with chronic, disabling health conditions. The website offers fact sheets on conditions such as dementia, Parkinson disease, and stroke as well as statistics, public policy information, and reports. It includes caregiver advice and tips and hosts online discussion groups. Information is available in English, Spanish, Chinese, Korean, and Vietnamese. The FCA is a nonprofit, community-based organization.

Medicare.gov – http://www.medicare.gov/

The official U.S. government website provides a wealth of information on Medicare health plans, drug coverage, and costs. It also offers tools to find whether a test, item, or service is covered and for finding doctors, providers, hospitals, plan, and suppliers. Online forms are provided for applying to the program, replacing a Medicare card, or changing an address. Information is available in English and in Spanish.

Medicine Safety: A Toolkit for Families – http://www.learnaboutrxsafety.org/
This excellent resource encompasses safe use, storage, and disposal of drugs; questions for your doctor and pharmacist; drug interactions and side effects; plus drugs of special concern for seniors and links to other resources. Medicine Safety is produced by the Center for Improving Medication Management (CIMM) and the National Council on Patient Information and Education (NCPIE).

Needy Meds – http://www.needymeds.org

Needy Meds is an information clearinghouse of the various assistance programs available from pharmaceutical manufacturers for patients who cannot afford medications. It also has information about government assistance programs and coupons.

RxList-The Internet Drug Index – http://www.rxlist.com
This site has information about prescription and non-prescription drugs, herbs, and supplements, and is searchable by generic and brand name. It also has a useful pill identifier tool, information and slide shows about diseases and health topics, and a medical dictionary.

National Center for Complementary and Integrative Health (NCCIH) – https://nccih.nih.gov/
The National Institutes of Health established NCCIH to study the safety and efficacy of complementary and alternative therapies. The website provides evidence-based information about these therapies, advice about choosing practitioners, and information about herbs and supplements.

Patient Decision Aids: https://decisionaid.ohri.ca/AZlist.html

Diabetes Decision aid – https://diabetesdecisionaid.mayoclinic.org/

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Immigration Physical

IMMIGRATION PHYSICALS

Tricity Family Medicine & Urgent Care Clinic is pleased to offer immigration physical services. Dr. Patel is a licensed US Civil Surgeon who has been authorized by the Bureau of Citizenship and Immigration Services to conduct Immigration Physicals for the Department of Homeland Security. Individuals applying for citizenship or seeking Permanent Residency or a Green Card are required to obtain an immigration physical performed by a designated Civil Surgeon prior to approval of their application. The exam results will be recorded on Form I-693 for the applicant to return to the USCIS (INS). The exam process generally takes 1-3 days, depending on whether a tuberculosis test (PPD) is needed. Call Tricity Family Medicine & Urgent Care today to schedule an appointment: 919-363-8666.

Services & Fees

Complete Immigration Physical Examination

The cost of the complete Immigration Physical Examination can vary on case to case basis as it may include required immunization and blood work along with Physical Examination:

Physical Examination
Review of your written vaccination and other health records
Syphilis test (RPR)- Required for applicants 15 and older, or possibly younger based on the physician’s determination.
Tuberculin skin testing and interpretation. This is required for applicants 2 and older. This test requires a return visit to the office within 48 – 72 hours after administration. If the test reading is positive, a chest X-ray will be required. The cost of the X-ray, should it be necessary, is not included in the price of the immigration exam but can be performed on site for an additional fee.
Certified and Sealed I-693 form with a copy for yourself
Copies of your laboratory testing

Physical Exam Only: If you only require a physical exam the cost is $250.00

Additional services that may be required, such as required vaccinations, additional certified copies of exams, blood tests for immunization status and follow-up chest x-ray for TB testing are not included in the price of the exam. If vaccinations are required, they may be obtained here at the time of the exam, at your primary care physician or we can arrange for them at a local immunization clinic at an extra fee that will be paid to the clinic. We do have all the required adult vaccinations and have many, but not all, of the required pediatric immunizations at Tricity Family Medicine & Urgent Care. Please call us for any questions or for pricing. Any questions as to what specific vaccination is required will be answered by the civil surgeon during the exam.

3.What To Bring

Valid, government issued picture ID such as a valid passport (preferred), driver’s license, greencard, or military ID.
Medical records (translated to English by an official translator, if necessary), including proof of prior treatment for tuberculosis or other infectious disease and prior chest x-rays
Immunization records (translated to English by an official translator, if necessary)
Any mental health records (translated to English by an official translator, if necessary)
An immigration physical form I-693, pre-completed with your information IN CAPITAL LETTERS. Please make sure this form is up to date (see the expiration date in the upper right or lower left corner).
Please budget at least 2-3 hours for this process on the first day and a total of 1-4 days depending on the necessity of PPD skin testing and availability of lab results (Friday and weekend exams may take longer for labs to process). Additional labs may be needed at an additional expense and may require up to 1-2 weeks for a result, depending on the test.

After The Exam

Once the immigration medical examination is completed and all immunizations and/or lab tests have been performed, we will provide you with a certified form I-693 in a sealed envelope to present to the Department of Homeland Security and U.S. Citizen and Immigration Services. DO NOT OPEN THE SEALED ENVELOPE. Turn in the envelope with your immigration application. A copy of your blood tests results and exam will be provided for you to keep after results have been discussed with the doctor. The medical examination will only be valid up to a year after the immigration exam date.

Typically, you will be notified of the results of your lab work (and chest x-ray, if done) within 7-10 days. If you have a health condition requires that medical follow-up, clearance will not be granted until follow-up is completed. You will be responsible for the cost of any additional medical examinations or treatments required to fulfill the federal health requirements established by USCIS.

While Tricity Family Medicine & Urgent Care has bilingual and multilingual staff (English, Hindi & Gujarati) available, it is your responsibility to bring a translator and have all your necessary immunization and medical records translated into English by an official translator to expedite your exam process.

All remaining expenses must be paid at the time of your exam. We accept cash Visa and MasterCard.

Visit the Official US Citizen & Immigration Services website for more information

Useful Documents:

Immigration Physical Form I-693
Further information about vaccine preventable diseases can be found on the CDC website at http://www.cdc.gov/vaccines/vpd-vac/vaccines-list.htm
Vaccination Requirements
Immigration Forms may be found at: http://www.uscis.gov/portal/site/uscis/menuitem.eb1d4c2a3e5b9ac89243c6a7543f6d1a/?vgnextoid=db029c7755cb9010VgnVCM10000045f3d6a1RCRDHYPERLINK
vaccination Requirements FAQ

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Recommended Medical Care

Preventive Care.
Good health begins with good preventive care. We recommend the following preventive care for your family.

Women age of 20 – 35
Annual pap smear, annual exam/physical

Women age 35 -40
Pap smear, annual exam/physical and mammogram

Women over age 40
Annual pap smear, annual exam/physical and mammogram

Men up to age 40
Physical once every 3-5 years

Men age 40-50
Physical every two years

Men over age 50
Annual Physical

All adults over age 50
Flexible sigmoidoscopy once every five years
Stool blood screen for colon cancer annually

Infants/Children
All vaccinations as recommended by American Academy of Family Practice

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Preparing for your visit

Please carefully read and understand your health care insurance policy’s coverage. Because insurance policies vary, we do not always know what your policy will pay.

Some policies require co-payments, which will be collected when you check in for your appointment/service. Some policies require co-insurance, which will be billed to you once your insurance carrier has advised us of their payment and your responsibility.

Some items or services are not covered by insurance. For information about how your plan will process charges for a service provided, please contact your insurance company directly. The Insurance Plan customer service phone number is found on your insurance card.

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Allergy Immunotherapy

The best method for controlling allergies is avoidance. Specific control of the offending environment(s) is essential in reducing or interrupting exposure. When sufficient relief cannot be achieved with avoidance techniques and medications, immunotherapy injections can be administered with the goal of reducing your sensitivities. Immunotherapy is effective for those allergic to: pollens, dust, mold spores, fungi, and some animal dander.

These injections are usually administered weekly for the first year and then a few weeks apart, depending on your symptoms. After a three to five year period, your allergy injections will be gradually tapered off. Some patients find it necessary to continue with a maintenance dose every four to six weeks for several years.

To reduce your sensitivities, the strength of your dose is gradually increased until you reach the maximum symptom-relieving dose. Occasionally, you may have a local reaction at the injection site, such as redness and swelling.

Interruptions in your progress can occur if you have an infection, are under stress, or have other medical problems which are not controlled. Excessive exposure to pollens, dust, molds or irritants in your environment (e.g. cigarette smoke, chemicals, metals, paint fumes, perfumes) may cause an increase in your symptoms. It may be necessary to adjust your allergy dose and to take allergy medication. Immunotherapy is not a cure for allergies and cannot provide 100% protection. You must take an active role in adjusting your environment to achieve the desired effect.

Allergy Test Insurance Verification Codes and Questions to Ask

We strongly recommend you to verify coverage of the following services/supplies by your insurance company prior to beginning allergy testing. The following codes are provided to help you when contacting your insurance company :

Allergy Skin Prick Testing for Foods and Initial Step of MQT test
– 95004 (per allergen)

Allergy Immunotherapy Treatment Vials
– 95165 (single/multiple antigens)

Allergy Injections
– 95115 (single injection)
– 95117 (two or more injections)

Questions to ask your Insurer(s):
• Are there any waiting periods or pre-existing clauses?
• Do I have any deductibles that apply in this case?
• Do I have any co-payments that apply in this case?
• Do I need a referral from my primary care physician (PCP)?
• What is the effective date when coverage/noncoverage begins?
• What percentage of my testing is covered?
• Do I have coverage for allergy immunotherapy serum and injections?

• Do I need prior-authorization or pre-approval from insurance for test?

Review all of the above codes with them

SKIN TESTING FOR ALLERGIES
Frequently Asked Questions

What Is An Allergy Test?
An allergy skin test, also called a scratch test, is used to identify the substances that are causing your allergy symptoms. It is performed by applying an extract of allergen to your skin, scratching or pricking the skin to allow exposure, and then evaluating the skin’s reaction.

What Happens During The Test?
First a doctor or nurse will examine the skin on your forearm and clean it with alcohol.

Areas on your skin are then marked with a pen to identify each allergen that will be tested. A drop of extract for each potential allergen—such as pollen and animal danderis placed on the corresponding mark.

A small disposable pricking device is then used so the extract can enter into the outer layer of the skin, called the epidermis. The skin prick is not a shot and does not cause bleeding.

If there are allergic antibodies in your system, your skin will become irritated and may itch, much like a mosquito bite. This reaction means you are allergic to that substance.

How Long Does The Test Last?
It takes approximately one hour for the entire appointment. The allergen placement takes 5 to 10 minutes. Then you will have to wait about 15 minutes to see how your skin reacts.

How Can I Prepare For The Test?
Inform the healthcare provider who is going to perform the skin test about all medicines you are taking, including over-the-counter medications.
Since over-the-counter antihistamines stop allergic reactions, you should not take them for five days before the test. Talk to your doctor about discontinuing your prescription medications prior to the test.

Your doctor will give you a list of medicines to avoid before the test, since there are other drugs that can interfere with the results. Since you may not be able to discontinue certain medicines, please consult your doctor or nurse before making any changes.

Will It Hurt?
The testing may be mildly irritating, but most people say it doesn’t hurt too much.

Is The Test Safe?
Although small amounts of allergens are introduced into your system, a skin test is completely safe when performed properly.

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Metabolic Testing

ENERGY BALANCE

One thing holds true in weight management and that is Energy Balance. Simply put, if you burn more energy than your body absorbs, you will lose weight and vice versa. When food is absorbed into your body it must either be burned as energy or stored as fat.

Achieving your ideal weight begins with finding the right balance of exercise and caloric intake. But each person’s balance is unique. Your Resting Metabolic Rate (RMR) can put you on the path to healthy living. Everyone has a unique number – find out yours.

YOUR RMR
• Measures the number of calories your body burns at rest.
• Is determined by measuring the amount of oxygen you consume while resting.
• Tells you how many calories you would burn in a day – if you rested the entire day.
• Can help you determine how many calories you should be eating each day to maintain, gain or lose weight.

We use the latest ReeVue Indirect Calorimetry to measure Resting Metabolic Rate (RMR). After the test, we will calculate your ideal caloric intake based on your activity level and individual weight goals.

Contact us today at 919-363-8666 (Holly Springs) or 919-261-6446 (West Cary) to schedule your Resting Metabolic Rate analysis.

The Resting Metabolic Rate Test is covered by health insurance. Your co-pay and deductible requirements will apply. Our staff will be glad to verify your coverage for the test.

For self-pay patients, the Resting Metabolic Test is $65.00.

What to Expect – It is as easy as 1-2-3!

1. RELAX.
REEVUE measures resting metabolic rate. It is important that you be able to reach a resting state during your test. You should avoid activities such as exercise or stressful situations that will prevent you from relaxing for at least four hours prior to your test. Digesting a large meal, as well as taking stimulants, such as caffeine, can raise your metabolic rate and should also be avoided prior to your test.

2. GET HOOKED UP.
You will be able to sit or lie comfortably while being tested. The technician will then place a nose clip on your nose and you will be given a disposable mouthpiece to breathe through. This mouthpiece is connected to the ReeVue by a hose that will measure how much oxygen you are breathing out. It is very important that you breathe only through the mouthpiece so this measurement will be correct. Both the mouthpiece and the tubing are sterile items that will be used only for you.

3. BREATHE
Finally, you just sit back and breathe. The ReeVue will indicate when it has calculated your metabolic rate. This takes about 10 minutes. The more relaxed and even your breathing, the quicker it will be able to determine your resting metabolic rate.

IT IS JUST THAT EASY!! In just 10 minutes, we will know precisely how many calories your body is burning. Your diet can then be tailored to maintain the right caloric balance.

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Services

No Hassle, flat fee Office Visit (does NOT include any X-Ray, Labs or other services)-$185.00

Evening (after 5pm)/Weekend/Holiday Convenience Fee -$15.00

Please call our office with additional questions.

Please Note: Abnormal lab consult is not inclusive of listed prices.

Holly Spring Office

West Cary Office