INSURANCE BOOKLET

RFI H E A LT H P L A N O F N E V A D A

CONTENTS LETTER FROM DR. JOHN SIMON........................ 3 M I S S I O N.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 »» Average Days to be Seen................................................................................................................... 4 »» Customer Service .................................................................................................................................. 4 »» Average Turnaround Time.................................................................................................................. 4 »» Womens’ Imaging Department....................................................................................................... 5 »» Compliance Program............................................................................................................................ 5 »» Birad 0s....................................................................................................................................................... 6 »» Birad 4s and 5s........................................................................................................................................ 6

P O I N T S O F D I F F E R E N T I AT I O N . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 »» 3D Mammogram................................................................................................................................. 6-7 »» Breast Density.......................................................................................................................................... 7 »» Lifetime Risk............................................................................................................................................. 7

S I M O N M E D D I F F E R E N T I AT O R . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 »» Nuclear Medicine.................................................................................................................................... 8 »» DatScan....................................................................................................................................................... 8 »» Parkinsonian Syndrome....................................................................................................................... 9 »» CT at SimonMed................................................................................................................................... 10 »» MRI at SimonMed................................................................................................................................. 10

O T H E R D I F F E R E N T I AT O R S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 C A N C E L L AT I O N P R O C E S S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 I N C R E A S E D C O M M U N I C AT I O N . . . . . . . . . . . . . . . . . . . . . . . . . 1 2

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»» Critical Results........................................................................................................................................12 »» Goals............................................................................................................................................................13 »» Radiologist Hotline...............................................................................................................................13

M O DA L I T Y S E RV I C E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 3 »» Offerings....................................................................................................................................................13

N E VA D A L O C AT I O N S & S E R V I C E S . . . . . . . . . . . . . . . . . . . . . 1 4 w w w. s i m o n m e d . c o m

Leading the Way, SimonMed Imaging is one of the largest outpatient medical imaging providers and largest physician radiology practices in the United States.

We specialize in using the newest diagnostic imaging technologies and bringing them to the community in an affordable and accessible way. Our logo “See Tomorrow Today� recognizes that new technology can help provide a more accurate diagnosis but needs to be readily available and affordable.

John Simon, MD

In our physician practice we stress the importance of subspecialty work in order to use this technology in combination with clinical experience to provide the best care. We maintain an active continuing medical education program for our medical communities so that they can share in this goal.

Advanced technology can be expensive but a key part of our mission is to provide it at an affordable cost. SimonMed often saves patients a significant amount in their out of pocket costs and is a national leader in providing cost transparency.

A final part of our mission is to provide care in a supportive and service oriented environment for our patients, referring providers and staff and this reflected in our comfortable office settings and welltrained, compassionate staff.

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Dr. John Simon CEO/ Founder w w w. s i m o n m e d . c o m

OUR MISSION

Our average score is 97% Customer Service Satisfaction

SimonMed strives to provide best-in-class, affordable care through the use of advanced technology, patient-focused staff, and highly trained medical professionals.

AV E R A G E D AY S T O B E S E E N AV E R AG E PAT I E N T- WA I T T I M E : 2 DAY S At SimonMed we know that it’s crucial for our referring physicians and patients that wait times be minimal.

To that end we offer same day appointments (unless restricted due to authorization requirements). This decreases the stress for the patient and gives the referring physician timely information about any symptoms presented.

C U S TO M E R S E RV I C E 9 7 % C U S TO M E R S E RV I C E S AT I S FACT I O N In order to meet our mission to provide best in class customer service we put a great deal of emphasis on patient satisfaction. We measure customer service satisfaction using patient surveys with a current participation level of 40%. Our surveys query multiple aspects of the patient experience including scheduling time, professionalism of the Technologist, friendliness of the front office staff and even the cleanliness of the facility.

R E P O R T S - AV E R A G E T U R N A R O U N D T I M E

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AV E R AG E T U R NA R O U N D T I M E FO R N O N M A M M O I S 1 - 2 DAY S .

To provide superior services we provide an average turnaround time of 24 hours on all routine exams and 1 hour for all stat exams. Expedient reporting allows referring physicians to share results with their patients as quickly as possible and allows additional imaging to be ordered promptly if necessary.

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Women’s Imaging is a passion of ours at SimonMed

WOMEN’S IMAGING D E PA R T M E N T OV E R A L L – AT S I M O N M E D I M AG I N G W O M E N ’ S ’ I M AG I N G I S O U R PA S S I O N .

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We believe annual mammography allows for early detection that translates to higher survival rates.

Statistics have proven early treatment can often negate the need for more costly treatment such as chemotherapy, radiation and radical mastectomies.

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BIRAD 0’S 3D Mammogram is more accurate, detecting serious cancers 44% earlier than 2D alone

1 0 0 % O F B I R A D 0 ’ S FO L LO W E D U P W I T H I N 4 8 H O U R S When a SimonMed radiologist notates an image as Birad O, a SimonMed Women’s Care Coordinator will immediately follow up with the referring physician office to request referrals for additional diagnostic imaging and or ultrasounds as needed. At SimonMed, it is our goal to have all additional testing scheduled within 2-3 days. .

BIRAD 4’S & 5’S 10 0 % O F B I R A D 4 & 5 ’ S FO L LO W E D U P W I T H 2 4 H O U R S When a SimonMed radiologist notates a mammogram image as Birad 4 or 5, the referring physician is contacted immediately. Standard treatment protocol in these cases is a tissue biopsy which can also be provided by SimonMed. Results of the biopsy are then forwarded to the referring physician who can put the patients mind at ease or handle the referral to a specialist as necessary.

P O I N T S O F D I F F E R E N T I AT I O N 3D MAMMO

44% increase in invasive cancer detected with 3D Mammography 29% increase in the detection of all breast cancers 16% decrease in recall rate from screening mammography

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Breast tomosynthesis is a breakthrough in screening mammography that provides a clearer, more accurate view compared to digital mammography alone. Research on breast tomosynthesis in large populations consistently show improved breast cancer detection rates, especially earlier invasive cancers, and a decrease in call backs by 16%, which may lessen anxiety for patients.

Tomosynthesis produces a three-dimensional multi-slice view of the breast tissue that helps our fellowshiptrained breast radiologists identify and characterize individual breast structures without the issue of overlapping tissue. Several large clinical studies have shown that a 3D mammogram is more accurate, detecting serious cancers 44% earlier than 2D alone. 3D mammography is approved for all women who would be undergoing a standard mammogram regardless of age, breast type, screening/ diagnostic mammogram. .

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BREAST DENSITY

A Breast Risk Assessment Test can determine if a woman is at low, average or high risk

40% of women have dense breast tissue To improve our screening results, in February 2017, we decided to purchase iCad with Breast Density. This application scores the patient’s breast tissue and classifies them into 4 different categories of breast density: A (Fatty Breast Tissue) B (Scattered Fibroglandular) C (Heterogeneously) D (Extremely Dense)

These classifications increase consistency, and give our radiologists more information on the patient and the tools to better assess patient needs.

ABVS »» Automated Breast Volume Scanner (ABVS) by Siemens Healthcare »» Standalone system that also uses a high frequency, large-format transducer to acquire 3-D volumetric imaging of the breast »» For dense breasts and can improve breast cancer detection by 55% over mammography »» Supplemental screening options for women with dense breasts.

LIFETIME RISK

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A Breast Risk assessment test can determine if a woman is at low, average or high risk for breast cancer.

Knowing their risk is a necessity on making screening recommendations for them. Typically, women who are at high risk have a strong family history of breast cancer. According to the American Cancer Society other risk factors include race and ethnicity, those with dense breast tissue, those who started menstruating prior to age 12, and lifestyle-related factors such as drinking alcohol and body mass index.

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A Breast Risk Assessment Test can determine if a woman is at low, average or high risk

S I M O N M E D D I F F E R E N T I AT O R – NUCLEAR MEDICINE NUCLEAR MEDICINE Nuclear medicine, a medical speciality that involves administering a small amount of radioactive medication, called a radiopharmaceutical. This makes the patient radioactive for a short amount of time, due to the pharmaceutical medication. A special nuclear medicine camera detects the radiation, which is emitted (released) from the body and takes images or pictures of how the body physically functions. Many different organs can be imaged depending on the type of radioactive medication used. The radioactive medication is most commonly injected through the blood stream via a vein, but can be administered in different ways, including: »» ORALLY INGESTED »» INJECTED DIRECTLY INTO THE TISSUE BENEATH THE SKIN »» INJECTED INTO A SHUNT »» INJECTED INTO A JOINT »» OR INHALED (BREATHED IN).

One of the radioactive medications used at SimonMed is DatScan, which is used for evaluating Parkinsonian Syndrome.

D AT S C A N

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DaTscan is a radioactive drug which is injected into the bloodstream to highlight areas of the brain so that images can be taken with a special camera (called a single-photon emission computed tomography [SPECT] camera). If you are an adult with a movement difficulty, your doctor may decide to order this imaging test, along with other medical tests. If your movement difficulties are due to a parkinsonian syndrome or a similar condition such as essential tremor, DatScan can be the differentiator.

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SimonMed uses DatQUANT in the reporting of all DatScans with no extra cost to our patients

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TA K E AWAY n n S imonMed is the only outpatient Radiology facility in Nevada that offers DatScan to our patients. n n Patient are scheduled within a week or less n n No Extra cost to patients

In addition to the commitment to our patients and referring providers, SimonMed also uses DatQUANT in the reporting of all DatScans with no extra cost to our patients~

DatQUANT is software that assists in the detection and quantification of SimomMed’s DatScans.

The investment in this technology has helped SimonMed continue to stand out amongst the competitors.

Patients continue to benefit from a company that invests into better imaging for best outcomes.

PA R K I N S O N I A N S Y N D R O M E Parkinsonian syndromes (PSs) are a group of disorders (Idiopathic Parkinson’s disease, Multiple System Atrophy, and Supranuclear Palsy) that may occur when there is a reduction in the ability of dopamine, an essential chemical that works in the brain, to function normally.

Dopamine affects many normal brain functions, impacting our behavior, thought, attention, sleep, motivation, and movement. There may also be a loss of proteins called dopamine transporters, known as DaT, which may also impact how dopamine functions in the brain.

CHALLENGES IN DIAGNOSIS In several studies, it was discovered that there was a tendency to misdiagnose PD and ET. In one clinical study, about 26% of patients receiving medication to treat PD had been misdiagnosed; they did not actually have PD1

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In another study, 37% of patients with an initial diagnosis of ET were declared to be misdiagnosed after further clinical evaluation2

REFERENCES: 1. Meara J, Bhowmick BK, Hobson P. Accuracy of diagnosis in patients with presumed Parkinson’s disease. Age Ageing. 1999;28:99-102.

2. Jain S, Lo SE, Louis ED. Common misdiagnosis of a common neurological disorder. Arch Neurol. 2006;63:1100-1104.

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SimonMed answers the call for lowered radiation scans

C T AT S I M O N M E D LO W D O S E CT SimonMed uses AlARA (As Low As Reasonably Achievable) CT Protocol

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»» Minimizing Radiation dose for patient safety is a priority

ASIR - GE / SAFIRE -SIEMEN »» Adaptive Statistical Iterative Reconstruction - ASIR »» Software that reduces radiation dose even lower than Standard ALARA Protocols »» 50% to 80% radiation reduction. »» Sinogram Affirmed Iterative Reconstruction - SAFIRE

TA K E AWAY n n Investing in patient safety n n T he concerns of excessive radiation exposure called for lowered

radiation scans and SimonMed answered. n n No extra cost to patients

M R I AT S I M O N M E D F O R T H E R E F E R R I N G P R O V I D E R S N E U R O Q UA N T ( N Q ) »» Used by medical professionals to aid in quantifying atrophy and assessing neurodegenerative diseases »» First FDA cleared, CE marked, and Health Canada, Australia, and Korea licensed software for volumetric MRI processing

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»» Provides volumetric measurements of brain structures and compares the volumes to a normative database adjusted for age, gender and intracranial volume

T H E R E A R E A TOTA L O F 5 N E U R O Q UA N T ( N Q ) R E P O RT S * : »» General Morphometry »» Age-Related Atrophy (Alzheimer’s Disease Assessment) »» Hippocampal Asymmetry (Temporal Lobe Seizures) »» Multi-Structure Atrophy (Major Structures) »» Triage Brain Atrophy

»» A powerful tool to help physicians evaluate patients from ages 3 to 100 »» Automatic image segmentation from radiographic images (3D T1 MRI)

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SimonMed continues to set higher standards for the Radiology Industry

L E S I O N Q UA N T ( LQ ) »» Automated quantitative lesion identification software

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»» LesionQuant module of NeuroQuant is FDA cleared »» Reports anatomical distribution of lesions »» Volume and %ICV of all, new and enlarging lesions »» White matter lesion burden calculation *These will appear in the patient exam folder in PACS every time NQ and LQ are processed

TA K E AWAY SimonMed Imaging investments in NeuroQuant (NQ) and other systems continue to set higher standards for the Radiology industry. n n No extra cost to SimonMed’s patients n n Done at all of our 3T MRI sites in Las Vegas

OT H E R S I M O N M E D S E RV I C E D I F F E R E N T I AT O R S

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Free Transportation

Personal Assistant Program for Providers

Same Day/Next Day Appointments

EMR integrations

7 convenient locations

Easy Access Web Based Online Portal Access

Community outreach

Multi-Specialty Radiology Practice

Subspecialty Radiology

On-Site ISTAT Lab

Measured Customer service oriented care

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An attempt is made at the time of cancellation to reschedule the patient

C A N C E L L AT I O N P R O C E S S All Cancelled appointments are offered to be rescheduled at the time of cancellation. In addition, if unable to reschedule, the patient is placed on a worklist for future rescheduling by a SimonMed staff. After 3 attempts to reschedule the referring providers office is notified. If any appointments are cancelled during our confirmation call, the process remains the same.

INCREASED C O M M U N I C AT I O N C R I T I C A L R E S U LT S Communicating critical findings is a very important part of SimonMed’s reporting.

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At SimonMed we have a dedicated team to communicate all of the critical results to our referring providers.

Our communication of critical findings allows our referring physician to act quickly to provide the proper follow up treatment for the patient. Upon SimonMed reporting critical findings, we confirm that the report was received, if images are needed and if a consult with a Radiologist is also needed.

D I S C L A I M E R – If it is life or limb threatening the Radiologist will speak directly with the Referring Provider unless requested not to by the Referring Providers.unless requested not to by the referring providers.

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Thousands of physicians call this line each month; it is a point of differentiation for us

GOALS C R I T I C A L – 1 Hour U R G E N T – 2 Hours S I G N I F I C A N T – Same Day

RADIOLOGIST HOTLINE In addition, that same team is available for all referring providers to call and connect with a Radiologist about a report or simply to ask a question. Thousands of physicians a month call this line and is a true point of differentiation for us.

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S I M O N M E D I M A G I N G N E VA D A L O C AT I O N S & S E R V I C E S LAS VEGAS

M A R Y L A N D PA R K WAY

3560 E Flamingo Rd. Suite #100 Las Vegas, NV 89121

3061 S. Maryland Pkwy. Suite #102 Las Vegas, NV 89109

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3T MRI Ultra-sound Dexa 3D Mammo Fluoro Nuc Med Xray and Biopsy 128 Slice CT GE VCT ASIR Breast Biopsy

SUMMERLIN 7455 W Washington Ave. Ste #120 Las Vegas, NV 89128 »» »» »» »» »» »»

3T MRI Ultra-sound 3D Mammo Xray 128 Slice CT GE VCT ASIR Soft Tissue & Thyroid Biopsy

NORTH LAS VEGAS 4640 W. Craig Rd. North Las Vegas, NV 89032 »» »»

Stand Up/Open MRI 0.6T Xray

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3T MRI 64 CT Ultra-sound Xray C-ARM

NORTHWEST 7610 W. Cheyenne Ave Ste 100 | Las Vegas, NV 89129 »» »» »» »»

3T MRI Wide Bore 64 slice CT Ultrasound Fluoro and Xray

CENTENNIAL HILLS

7540 Oso Blanca Rd. Unit 140 | Las Vegas , NV 89149 »» »» »» »» »» »» »» »» »»

3T MRI 16 CT SAFIRE Ultra-sound 3D Mammo Xray Dexa ABVS PET/CT SAFIRE Nuc Med

HENDERSON

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6301 Mountain Vista. Suite #103 Henderson, NV 89014 »» »» »» »» »» »»

3T MRI 16 CT Ultra-sound 3D Mammo Dexa and Xray PET/CT

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RFI

H E A LT H P L A N O F N E V A D A www.simonmed.com