Getting Started with AT-GC

A what-to-expect-guide for your telehealth genetic counseling journey with Advanced Tele-Genetic Counseling

The Genetic Counseling Journey

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Comprehensive

Genetic Counseling

Genetic counseling is the process of supporting patients and providers understand and navigate the complex world of personalized genomics.

When an individual  meets with an AT-GC certified genetic counselor as a new patient, here is what to expect.

 

Together with you, the genetic counselor:

  • Reviews and compiles your personal and family genetic health history, dating back three generations, if possible.
  • Completes and discusses your genetic risk assessment and identifies your personalized genetic risk factors.
  • Reviews relevant testing options that may be appropriate for you, or interprets the results of existing genetic testing results, if you have them.
  • Explains in detail the benefits and limitations of the genetic testing most applicable for you and supports you in your decision to have or not have genetic testing.
  • Works with you and/or your healthcare team to help facilitate and coordinate genetic testing, if warranted. DNA samples can often be mailed in without you needing to leave the house.
  • After genetic testing, your provider or your genetic counselor informs you of your specific results. The genetic counselor will meet with you to ensure that genetic testing results are received and fully understood.
  • Provides follow-up support for genetic testing results by helping outlay the meaning of specific genetic findings and their potential implications for your health and/or the health of your family members.
  • Communicates with your healthcare team to share next-steps information for your wellness, health management, and follow-up, should recommendations exist following genetic testing results.
  • Determines who in the family is also at risk for any genetic findings.
  • Provides easy-to-understand interpretation of any complex genetics results into meaningful records for your ongoing care.

 

Frequently Asked Questions

 

 

What is an inherited condition?

An inherited condition is a medical condition or a trait that can be passed down from parent to child. Genes are the instructions that our bodies use to grow and function. If one of these genes has a change in it, this may effectively change the function of the gene. Sometimes, these changes mean that the gene  does work correctly, which can put us at a higher risk for developing health symptoms related to having a variation in that specific gene.

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How can genetic counseling help me? How can it help my family?

Meeting with a genetic counselor can help you learn more about the specific genetic risk factors in your family.

Based on your genetic test results, your doctor may want to offer specialized screening or management options to keep you healthy.

You may want to consider ways to reduce the chance of developing symptoms related to specific genetic findings.

You could share information with your relatives so they can determine their own risk of developing certain genetic conditions and stay healthy.

What questions are asked at a new patient genetic counseling appointment?

 

In order to get a clear picture of your personal genetic risk factors, it may be requested that you complete a personal and family health history prior to and/or during your meeting with the genetic counselor.

 

This helps the genetic counselor understand who is at risk, and what they may be at risk for from the perspective of hereditary conditions.

 

Some of the detailed topics you will discuss include:

  • Which relatives have had symptoms that may indicate an underlying genetic condition?
  • How old were they/you when they/you developed these symptoms?
  • What type of symptoms did they have?
  • Has anyone in the family had a diagnosis of a genetic condition?
  • Are you or others in your family adopted and seeking more information about genetic health risks?
  • Have you or a family member already had some  genetic testing? If so, what were the results?

Does your practice accept insurance?

Advanced Tele-Genetic Counseling is out-of-network with all commercial health insurance plans. AT-GC does not accept Medicaid, Medicare, or Tricare, including managed plans. 

Will my insurance pay for genetic counseling? 

Genetic counseling is a covered service under many commercial health insurance plans and patients with out-of-network coverage may find that the service is a reimbursable expense. We are happy to help provide documentation to pursue this option.

 

How will you bill me?

Payment for genetic counseling is collected securely via verified credit card or HSA payment through the AT-GC Client Portal. 

 

What are the fees for genetic counseling?

AT-GC is committed to providing exceptional patient care through rapid telehealth availability for people seeking to understand and manage their genomic risks.

Our New Patient Comprehensive Genetic Counseling service is a one-time payment that includes both initial and results counseling, as needed. 

Visit the AT-GC Scheduler to view current new patient appointment availability and to learn more. 

 

 

 

I hear there is often follow-up involved in genetic counseling. Do I have to pay for this? 

Genetic counseling involves an initial consultation that includes review of personal and family histories, personalized risk assessment,  review of existing genetic testing, and discussion of any genetic testing that may be appropriate for you.

If you pursue additional testing, your genetic counselor will help coordinate the test with you and/or your local provider.

Results (post-test) genetic counseling — including a review of genetic testing results, medical management recommendations, implications for family members, and follow up with your provider so you can take control of your genetic wellness journey — is included in your initial payment, meaning you pay once and receive comprehensive care tailored to your needs. 

Does your practice offer financial assistance?

We are a small, woman-owned practice whose goal is to help make genetic counseling accessible to individuals who need it. AT-GC offers financial assistance via a reduction in fees for patients who meet certain criteria and who are able to provide the required supporting documentation. You may request a copy of AT-GC’s Patient Assistance Application by emailing our AT-GC Care Team Coordinators.

To see if you may qualify, please first consult the poverty guidelines updated periodically in the Federal Register by the U.S. Department of Health and Human Services under the authority of 42 U.S.C. 9902(2).  Payment for genetic counseling is collected securely via verified credit card or HSA payment through the AT-GC Client Portal. 

 

Is genetic counseling right for me? 

Understanding the impact of genetics on your health and the health of family members is often a powerful tool that individuals and families can use to know their risks and to learn about ways they can stay healthy or manage these risks.

 

People seek genetic counseling for all sorts of reasons.

 

People come to see AT-GC’s genetic counselors because they are having symptoms that may be genetic in nature.

 

They also come to share existing test results and discuss further testing options.

 

Some healthy people want to know more about how to keep well, and genetic counseling can help clarify risk factors.

  Our genomes play a major part in some conditions, including: 

  • 1 in 10 cases of cancer 
  • 1 in 2 cases of infertility 
  • 3 in 10 cases of heart disease 
  • 1 or 2 in 10 cases of certain neurodegenerative disease

In all instances, it is an individual’s decision to pursue or decline any exploration of genetic testing. 

What is the Genetic Information Non-Discrimination Act?

The Genetic Information Non-Discrimination Act (GINA) is a federal law passed in 2008. It and other state laws help protect most people undergoing genetic testing against health insurance discrimination and employment discrimination.

Is AT-GC affiliated with a particular genetic testing laboratory?

As an independent genetic counseling provider, AT-GC does not support any particular genetic testing laboratory. Instead, genetic counselors use the information discussed during the new patient appointment and references the patient’s unique personal and family health history genetic counseling evaluation when considering which genetic testing is most appropriate.

 

Do you access and/or store my DNA?

AT-GC does not have access to, nor does it store, biological patient samples.

Samples are submitted by the patient or the patient’s physician directly to the selected genetic testing laboratory.

AT-GC genetic counselors can help guide you regarding the policies laboratories have with regard to preservation and protection of your DNA samples, as not all laboratory policies are equivalent.

 

 

Proactive Wellness and Genetic Testing
Genetic counseling is appropriate for all who want to understand more about the influence of their inherited genetic information and associated health risks   Genetic counseling is useful for understanding personal or family history of suspected genetic conditions, and for those without access to, or knowledge of, their biological family medical history   Genetic counseling is warranted both for those experiencing symptoms and for healthy individuals who seek personalized preventive health information about their genetic risks   Genetic counseling is useful in understanding clinician-ordered genetic testing as well as the benefits and limitations of DTC commercial and ancestry test results 
Cancer

1:10 of all cancers are related to genetics 

Genetic counseling is currently recommended for personal or family history of certain cancers, such as ovarian and pancreatic in  any blood relative  

Genetic counseling is often appropriate for personal or family history of hereditary  breast,  colorectal, cutaneous melanoma, gastric, prostate, renal cell, uterine, and thyroid cancers, among others

 

Family or personal history of similar or aggressive cancer types, bilateral primary cancers in paired organs, multiple cancer diagnoses, or cancers occurring more frequently or at younger ages than would be expected

Reproduction
1:2 cases of infertility may be explained by genetics   Knowing genetic risks may help with the fertility journey  

Genetic counseling is useful for individuals or couples planning a pregnancy, and for those who are expecting and wish to know more about genetic risks 

Genetic counseling is offered for advanced maternal (+35 years) or advanced paternal (+40 years) age, and for all who want to know more 

Genetic counseling is useful for carrier testing and screening such as PGT (PGS/PGD) and prenatal diagnostic testing

Genetic counseling for a history of miscarriages, stillbirths, or history of symptoms in the family that may be genetic 

Ocular
30% of cataract cases are related to genetics

Genetic counseling is important for understanding histories of early-onset vision changes, such as blindness, glaucoma, macular degeneration, and retinal degeneration

Genetic counseling is important for other conditions of the eye that are suspected to be genetic in nature, such as retinal or corneal dystrophies, inherited strabismus, and colorblindness 

 

Pharmacogenomics 

Pharmacogenomic testing explores how an individual may respond to common drugs and can help prevent adverse reactions and provide efficacy information for dosage and type

Genetic counseling for physician support when considering certain FDA labels recommending pharmacogenomic testing for medication and treatment decisions to prevent severe, adverse drug reactions

Used for physician treatment decisions in oncology, heart and lung disease

Genetic counseling may be useful for individuals with anxiety, ADHD, autism/ASD, major depression, bipolar disorder, panic disorder, or a personality disorder, or schizophrenia who are under the care of a psychiatrist
Cardiology

30% of cases related to heart disease, high blood pressure, and cholesterol run in families

Genetic counseling is important for personal or family history of aortopathies, arrhythmias, and cardiomyopathies

Understanding cardiac genetic risks through genetic counseling is important for families with a history of early heart attack, thoracic aneurysm, congenital heart disease, or sudden cardiac death

 
Surgery

Genetic counseling for patients undergoing surgery with a suspected or known family or personal history of genetic disease

Genetic counseling support for surgeons requiring assessment of genetic predisposition for pre-surgical and post-surgical decision-making and care

Neurology

30-40% of epilepsies are inherited

15% of ALS (“Lou Gehrig’s disease”) or Parkinson’s disease cases are inherited Genetic counseling is warranted for Huntington disease Some cognitive conditions, such as early-onset Alzheimer’s disease and dementia, run in families 

Genetic counseling is important for neurodevelopmental delay or other conditions, including ataxias, lysosomal storage disorders (such as Gaucher, Niemann-Pick, and Fabry diseases), neuofibromatosis cases, and neuropathies (such as Charcot-Marie-Tooth)

Family/Personal History

Genetic counseling for family history of similar conditions or symptoms that appear, especially in multiple family members, those on the same side of the family, and sometimes with more frequency, with severity, or at earlier-than-typical ages

Genetic counseling for symptoms that you or your provider are concerned about that appear to be genetic in nature

 What  are some family or personal health history scenarios that may mean genetic counseling should be considered?

  • Earlier disease onset than typical ages
  • Especially severe or exceptional disease presentation
  • Multiple diagnoses or  similar types of disease in the same person or in multiple family members on the same side of the family
  • Multiple congenital (present at birth) anomalies
  • Recurrent pregnancy loss
  • Sudden death
  • Developmental delays
  • Family history of a known inherited disorder
  • Limited/unknown family history

We Support You

at-gc supports all individuals seeking to know more about their genetic risks

 

Why Telehealth, Why AT-GC

 

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Our team of certified genetic counseling experts provides comprehensive genetic counseling for the patients we are lucky to serve.

 

With national coverage, we understand that, like our individual genomes, every patient is unique.

 

Our practice strives to meet patients and partners where they are, wherever that may be, to provide world-class genetic counseling when and where and for all who need it.

 ACCESS

 

Access to healthcare should not be dependent on where you live. With a  long-term, global  deficit of genetic counselors            among increasing demand for genetics evaluations, AT-GC’s tele-genetic counseling support services are an essential tool for achieving health equity across practices and for all patients. We are passionate about providing a solution by connecting patients and providers to qualified genetics professionals.

 

TIMELY

 

Telehealth provides ease of scheduling for patients who may otherwise lack the ability, time, or resources to meet with an in-person genetic counselor. For practices and larger health organizations, partnering with AT-GC means no more unfilled genetic counselor positions, no training and overhead, and no problems with retention. We’re ready to help, anytime, and anywhere. 

QUALITY

 

Patients who complete a genetic counseling appointment with an AT-GC genetic counselor report an accurate perception of their risks and say that the experience exceeded their expectations. There is no difference in patient knowledge or satisfaction compared to in-person genetic counseling. AT-GC’s genetic counselors are board-certified by the American Board of Genetic Counseling and proudly uphold    what it means to be a Certified Genetic Counselor.

AFFORDABLE

It is our goal to help increase access and to today’s high-performing, knowledgeable genetic counselors for all who seek to know more about the influence of heredity on our personal well-being. AT-GC’s scalable platform translates into substantial cost-savings for our patients and partners.  AT-GC is dedicated to finding solutions to support patient care across our communities for all who need them.