REP TRAINING

Your Clinical Trials Experts At AmeriMed

Solutions, we handle your clinical trials from start to
finish. We submit all regulatory documents, negotiate
top dollar for each patient, and place a qualified clinical
research coordinator to handle day to day procedures
and patient visit protocol. We keep the patient at the
center of everything we do.

INCREASE PROFITS NEW PATIENTS NEW TREATMENTS RESEARCH NOTERIETY

Assessment

Our Partners

• GlaxoSmithKline • Abbott Pharmaceutical
• Pfizer Companies
• Aguoron • Roche Treatment
• PPD • Chiron

• CTMS • Parexel

• Bristol Myers • Trimeris
• Merck
• Triangle

CLINICAL RESEARCH NEW
COORDINATOR THERAPIES

• We handle everything from • We market your clinic to the
beginning to end pharmaceutical companies that
match your patient population
• Increase profits for your practice
• Submit all regulatory documents
• Clinical research represents new for approval
hope for your patients
• Negotiate top dollar for each
patient enrolled in the trial

"Your Clinical Trials Experts" At AmeriMed

Solutions, we handle your clinical trials from start to
finish. We submit all regulatory documents, negotiate
top dollar for each patient, and place a qualified clinical
research coordinator to handle day to day procedures
and patient visit protocol.We keep the patient at the
center of everything we do.

BENEFITS OF CLINICAL TRIALS

INCREASE PROFITS

Generate an additional $2,000.00 -
$30,000.00 per patient

RESEARCH NOTERIETY

Become published in that study and
considered a specialist

NEW PATIENTS

Introduce New Patients to your practice

NEW TREATMENTS

Clinical Research represents new hope for
your patients

WE HANDLE EVERYTHING

We handle the clinical trial from beginning
to end.

Clinical Trials Survey

Potential Principal Investigator Information
PI First Name: _________________________________________
PI Middle Name: _______________________________________
PI Last Name: _________________________________________
PI Specialty: __________________________________________
PI Phone: ____________________________________________
PI Email: ____________________________________________

Institution Name : _____________________________________
Institution Address: ____________________________________
City, State, Zip: _______________________________________

Primary Study Contact Information

First Name: __________________ Last Name: ______________________

Title: __________________ Phone: _______________________________

Email: _____________________________________________________

Please select the option that most closely describes the investigative site.

o Academic Institution/ University Clinic
o Hospital
o Multi-Specialty Group Practice
o Public Health Clinic
o Research Dedicated Center
o Single Specialty Group Practice
o Solo private practice
o Other, please specify: _________________________________

Has principle investigator participated in clinical trials?
o No
o If Yes, please list studies.
__________________________________________________________

__________________________________________________________

Staff

How many physicians at clinic? __________________________________
How many PA’s: _________________ Nurse’s: ____________________
Office Managers: _________________ Front desk: _________________
Any office employees able to help with study?: ______________________
If so, who?: __________________________________________________

Clinic Size

How many locations: __________ Square footage: ___________________
How many offices: ____________ Exam rooms: _____________________
Laboratory area: ______________ Lab area sq. ft.: ___________________

Site Amenities

Area for us to work?: _______________ Sq. Ft. _____________________
Does site have handling area or storage facility to process biological
samples?: ____________________________________________________
Does site have a centrifuge? : _____________________________________
Does have biohazard waste container?: _____________________________

Does the site have the following? Check all that apply.

o Back up generator
o Mini refrigerator
o Full size refrigerator
o Pharmacy grade refrigerator
o –20 degree C freezer
o -70 degree C freezer
o Documenter yearly maintenance for storage facilities
o Alarms set up for refrigerators and/ or freezers
o SOP for power outage

Patient Demographics

What percentage of subjects in the site database are from the
following groups? (Total Should= 100%) % of patients/subjects

American Indian: _______________ Asian: ______________________

Black: _____________________ Hispanic: _______________________

Pacific Islander: _____________ White: _________________________

What is the average number of patients per month seen at the site in the
following age groups? Average number patient visits per month
Newborns (<3 months) __________________
Infants (3 to 23 months) __________________
Young Chilgren (2 to 9 yrs) ________________
Older Children (10 to 17 yrs) _______________
Adult (18 to 65 yrs) _____________________
Geriatric (>65yrs) ________________________

Describe the different patient symptoms and diagnosis that are in your
site database?: (The more diverse, the better chances for a study)

Example: ED, hypertension, diabetes, migrains, insomnia

Symptom/Diagnosis Number of patients

__________________________ _______________________________

__________________________ _______________________________

__________________________ _______________________________

__________________________ _______________________________

__________________________ _______________________________

Symptoms/ Diagnosis Number of patients

__________________________ _______________________________

__________________________ _______________________________

__________________________ _______________________________

__________________________ _______________________________

__________________________ _______________________________

__________________________ _______________________________

__________________________ _______________________________

__________________________ _______________________________

__________________________ _______________________________

__________________________ _______________________________

__________________________ _______________________________

__________________________ _______________________________

__________________________ _______________________________
Application completed by:

Name: ______________________________________________________

Title: _____________ Company name: ____________________________

Phone: __________________ Email: ______________________________

IntelleWave 1

Quantitative Assessment Of
The Autonomic Nervous System

“Autonomic Function testing and Real-Time Monitor of
Heart Rate Variability analysis”

Diagnostic Resources LLC,
the exclusive distribution network of the IntelleWave system.

Heart Rate Variability (HRV)

•  HRV testing provided by IntelleWave allows physician’s to monitor
the activity of both the Sympathetic (SNS) and Parasympathetic (PSNS)
branches of the Autonomic Nervous System (ANS) in order to assess
the state of a patient’s autonomic function.

•  IntelleWave can detect different specific types of Autonomic Dysfunction,
which can be linked to a multitude of clinical diagnoses.

•  IntelleWave is also a tool for overall, general assessment of a patient’s
physiology, and, as a physiologic monitor, it provides a comprehensive, in-
depth patient evaluation, often missing in standard medical practice.

What is IntelleWave?

Ø  IntelleWave is a 15 minute, non-invasive diagnostic test which can be run in any office by a
wide range of specialties. The test itself can be run by any office employee who has been
trained to run the program and apply the monitoring devices to the patient.

Ø  The physician’s role is to read and understand the test results so that a diagnosis can be
made on how to treat that specific patient.

Ø  The IntelleWave system does not determine what to do for a patient, rather, it will allow the
physician to see the balance of the autonomic nervous system which can determine
whether a patient is healthy or has some underlying issues.

Ø  IntelleWave will allow the physician to determine if their regimen of care practices has
been effective on that specific patient (ex. if the beta blockers receptors are not in balance,
perhaps the medication dosage is not correct or they’re resistant).

2

Training purposes only. No information may be used to either diagnose or treat a patient.

What’s included in an IntelleWave system?

ü  Laptop computer with
IntelleWave proprietary
software

ü  Blood pressure cuff and digital
monitor

ü  Blue tooth enabled ECG with
leads

ü  Pulse Oximeter

Interpreting the IntelleWave Test Results

The IntelleWave ANS Test is covered by
Medicare, Private Insurance & Workers
Comp.

The
 Following
 CPT
 Codes
 are
 used
 to
 bill
 for
 the
 IntelleWave
 ANS
 Test.
 
95943
 Tes8ng
 of
 the
 Autonomic
 Nervous
 System
 
93922
 Tes8ng
 of
 autonomic
 nervous
 system
 func8on;
 vasomotor
 adrenergic
 innerva8on,
 (sympathe8c
 adrenergic
 

func8on),
 including
 beat-­‐to-­‐beat
 blood
 pressure
 and
 R-­‐R
 interval
 changes
 during
 Valsalva
 maneuver
 and
 at
 least
 5
 
minutes
 of
 passive
 8lt
 

95927
 Short-­‐latency
 somatosensory
 evoked
 poten8al
 study,
 s8mula8on
 of
 any/all
 peripheral
 nerves
 or
 skin
 sites,
 

recording
 from
 the
 central
 nervous
 system;
 in
 the
 trunk
 or
 head
 
 

94760
 Pulse
 Oximetry
 


 

*Diagnos8c
 Resources
 will
 assist
 your
 Billing
 Department
 with
 any
 issues
 or
 denials,
 See
 Sample
 EOB’s
 
 
 

 

 

Benefits to the physician include:

1.  Strong ancillary tool for their practice.
2.  More comprehensive diagnosis for their patient’s.
3.  Better chronic care baseline measuring with documentation.
4.  Additional testing opportunities (i.e. ABI, Ultrasound, Doppler, EKG…

etc.).
5.  Risk Avoidance and Liability Protection
6.  Diagnostic Resources will help manage their database and assist with any

billing issues or denials.
7.  All tests will be stored in a HIPPA approved and bank standard secure

cloud to protect the data.

Ancillary Income
Revenue Assumptions

Next Steps:

1.  Complete Onboarding Forms
2.  Authorize Marketing Management Agreement
3.  Schedule IntelleWave Installation
4.  Schedule Staff and Doctor Training













 

What is IntelleWave?

Ø  IntelleWave is a 15 minute, non-invasive diagnostic test which can be run in any office by a
wide range of specialties. The test itself can be run by any office employee who has been
trained to run the program and apply the monitoring devices to the patient.

Ø  The physician’s role is to read and understand the test results so that a diagnosis can be
made on how to treat that specific patient.

Ø  The IntelleWave system does not determine what to do for a patient, rather, it will allow the
physician to see the balance of the autonomic nervous system which can determine
whether a patient is healthy or has some underlying issues.

Ø  IntelleWave will allow the physician to determine if their regimen of care practices has
been effective on that specific patient (ex. if the beta blockers receptors are not in balance,
perhaps the medication dosage is not correct or they’re resistant).

2

Training purposes only. No information may be used to either diagnose or treat a patient.

What’s included in an IntelleWave system?

ü  Laptop computer with
IntelleWave proprietary
software

ü  Blood pressure cuff and digital
monitor

ü  Blue tooth enabled ECG with
leads

ü  Pulse Oximeter

Interpreting the IntelleWave Test Results

The IntelleWave ANS Test is covered by
Medicare, Private Insurance & Workers
Comp.

The
 Following
 CPT
 Codes
 are
 used
 to
 bill
 for
 the
 IntelleWave
 ANS
 Test.
 
95943
 Tes8ng
 of
 the
 Autonomic
 Nervous
 System
 
93922
 Tes8ng
 of
 autonomic
 nervous
 system
 func8on;
 vasomotor
 adrenergic
 innerva8on,
 (sympathe8c
 adrenergic
 

func8on),
 including
 beat-­‐to-­‐beat
 blood
 pressure
 and
 R-­‐R
 interval
 changes
 during
 Valsalva
 maneuver
 and
 at
 least
 5
 
minutes
 of
 passive
 8lt
 

95927
 Short-­‐latency
 somatosensory
 evoked
 poten8al
 study,
 s8mula8on
 of
 any/all
 peripheral
 nerves
 or
 skin
 sites,
 

recording
 from
 the
 central
 nervous
 system;
 in
 the
 trunk
 or
 head
 
 

94760
 Pulse
 Oximetry
 


 

*Diagnos8c
 Resources
 will
 assist
 your
 Billing
 Department
 with
 any
 issues
 or
 denials,
 See
 Sample
 EOB’s
 
 
 

 

 

Benefits to the physician include:

1.  Strong ancillary tool for their practice.
2.  More comprehensive diagnosis for their patient’s.
3.  Better chronic care baseline measuring with documentation.
4.  Additional testing opportunities (i.e. ABI, Ultrasound, Doppler, EKG…

etc.).
5.  Risk Avoidance and Liability Protection
6.  Diagnostic Resources will help manage their database and assist with any

billing issues or denials.
7.  All tests will be stored in a HIPPA approved and bank standard secure

cloud to protect the data.

Ancillary Income
Revenue Assumptions

Next Steps:

1.  Complete Onboarding Forms
2.  Authorize Marketing Management Agreement
3.  Schedule IntelleWave Installation
4.  Schedule Staff and Doctor Training