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Who We Are CardiaCall ’s revolutionary approach to remote cardiac event monitoring materially changes your: n Level of care n Patient’s compliance/satisfaction n Remuneration

We become an extension of your practice, giving you and your patients added benefits and unprecedented access to remote cardiac event monitoring. In this challenging health care environment, CardiaCall’s model offers a unique opportunity for you, the physician, to control and bill for the services you provide, improving your practice’s efficiency while exceeding your patient’s expectations.

Patients

Physicians

CardiaCall Your Monitoring Service


3

Why is CardiaCall

O

Different?

ur proposition is unique! You own the monitoring device, the monitoring protocol is yours and we become an extension of your practice. This allows you to bill Medicare and other 3rd party payers using applicable CPT codes for the monitoring service. The CPT code includes: hookup and training, 30 days of attended monitoring (24/7) and interpretation. CardiaCall’s approach allows you to have more control over your patient’s monitoring experience, while giving you the comfort of knowing that notifications will be tailored to individual patients, according to your criteria. The entire monitoring procedure is simplified while the value realized by your practice is maximized. We pride ourselves on making the process economically and

logistically viable for solo practitioners as well as for large, group practices. Our Call Centers, staffed by Certified Cardiac Technicians, are ready to receive your patient’s calls and ECG transmissions and to forward reports to you in a timely manner per your prescribed protocols. Our job is to assure that your patient’s event-monitoring experience reflects the quality of service provided by your practice. If you have any questions related to our standards, processes, coding, billing or any other issue, please contact our experts at 1-800-220-9511. Call us to have a qualified sales representative review your needs and to present you with our remote cardiac event monitoring service programs.


4 Professional Team CardiaCall was founded by a team of seasoned, dedicated, highly-respected professionals with decades of combined experience in the medical industry and in the diagnosis and treatment of cardiovascular diseases. CardiaCall provides some of the most advanced remote cardiac monitoring solutions available. Our cardiac event monitors are state-of-the-art and come with a full warranty and guaranteed satisfaction. CardiaCall’s Receiving Centers are staffed 24/7/365 with experienced, certified cardiac technicians (CCTs/CVTs) to receive your patient’s data and to respond according to your orders (in full compliance with HIPAA guidelines).

Did You Know? n Event monitoring is the most useful tool for diagnosing arrhythmias n Event monitoring companies currently make 80% to 90% of the revenue while physicians incur 100% of the risk and ultimate responsibility for the patients well-being n Your Reimbursement rates depend on your contractual relationship with your payers; CardiaCall financial assumptions are at 120% of Medicare rates, which would increase your income ten fold.


How Physicians Benefit

In a Challenging Health-Care Environment CardiaCall rises to the challenge by offering outstanding service while improving the bottom-line of your practice and providing excellence in all aspects of remote cardiac event monitoring. Our services are designed to help increase patient compliance, decrease the amount of time required to diagnose an arrhythmia, and to help access emergency assistance, when necessary. CardiaCall enables physicians to give their patients the most accurate remote cardiac monitoring available. Our Call Center’s provide physicians with timely reporting per physician protocol by our credentialed and experienced CCTs/CVTs. We will follow your protocol for each of your patients and advise you per your customized instructions.

Take a Look at the Offering . . .

O

ther event monitoring companies currently earn 80% to 90% of the global code revenues for this service, while the physicians who refer to them, earn only a fraction of the global code while assuming all the risk and responsibility for the patient’s well being. The average national reimbursement for a 30-day monitoring code 93268 review and interpretation for 2010 is about $26.00 for the physicians; while event monitoring companies are paid

approximately $270.00 for the Technical & Hookup components of code 93268 in larger metropolitan areas. CardiaCall provides physicians with timely reporting by our credentialed and experienced team of cardiovascular technologists. Our high level of reporting and professionalism provides physicians with the confidence that CardiaCall will follow the notification protocols for the individual patients as prescribed.

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6

CardiaCall’s Model

O

ur Model has been carefully structured to provide you and your patients with the highest level of technical and personal care while complying with all Federal healthcare laws Including:

n n n

Federal Physician Self-Referral or “Stark Law�; Medicare Anti-Markup Rule; Federal Anti-Kickback Statute.

> Quality Assurance

CardiaCall is committed to provide the highest quality service to all patients. To do so, we require all cardiac monitoring staff to adhere to the Quality Assurance (QA) standards, policies and procedures developed by the Clinical Management Team. The primary goal of the QA plan is to assure adherence to our service quality standards and to ensure continual improvement in quality across all areas. Our QA plan is an integrative process that links knowledge, structures, and processes to enhance quality throughout the organization. (Example: A QA check of all ECG data is performed prior to an Ambulatory ECG Report being faxed, emailed or posted on our secure website physician portal.)

> Physician Notification CardiaCall clinical staff will contact the physician based upon notification criteria signed by the referring physician at enrollment. If a patient transmits an ECG that is within the physician notification criteria: n The patient will be instructed to record and

transmit a follow-up ECG. n The physician will be contacted and orders will be followed accordingly. n The ECG data will be faxed, emailed and/or posted to our secure website physician portal.

Our Unique Approach CardiaCall enables you, the physician, to own the monitoring device(s) while our monitoring center/service becomes an extension of your practice, allowing you to: n Closely monitor your patients and

their remote monitoring cardiovascular conditions n Bill Medicare and other 3rd party payers under the applicable CPT code for the monitoring service, including hook-up and training, testing, 24 hour monitoring and interpretation.


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Are You Ready To Be

Empowered?

CardiaCall will allow you to: n n n

More closely monitor your patients Appropriately bill the global billing code, and Increase your practice revenues

30 Days Cardiac Event Monitoring CPT 93268 (DC + MD/VA 2010) n

Interpretation

n

Technical Service

n

Patient Hook Up

Code Description   93268. Wearable patient activated electrocardiographic rhythm derived event recording with presymptom memory loop, 24-hour attended monitoring, per 30 day period of time; includes transmission, physician review and interpretation


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30-Day Cardiac

Practice’s Return on Inv

CMS Area DC + MD/VA Medicare Reimbursement: Patient Hook Up 93270 Technical (service & all components) *93271 Interpretation 93272 Total Reimbursment

Commercial Reimbursement*: Global 93268 OR Patient Hook Up 93270 Technical 93271 Interpretation 93272

Total Reimbursement Gross Average Reimbursement Assuming 40 % Medicare / 60 % Commercial Monthly Service Fee Per Patient* Net Average Revenue Per Patient to Practice Tests/Month

10 25 50

Revenue: Monthly CardiaCall

$2,318.37 $5,795.92 $11,591.84

Others

$327.60 $819.00 $1,638.00

Lost

$1,990.77 $4,976.92 $9,953.84

*Billing rate assumed at 120% of CMS/CPI code

Please note that these amounts are approximations and that your specific reimbursement may differ based upon your location and


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Event Monitoring

vestment (ROI) Example

CardiaCall Other Companies $20.15 $0.00 $245.99 $0.00 $29.25 $29.25 $295.39 $29.25

40% $354.47 N/A

$24.18 $0.00 $295.19 $0.00 $35.10 $35.10

$354.47 $35.10

$330.84 $32.76 $99.00 Revenue $231.84 vs. $32.76

Revenue: Annually

CardiaCall

$27,820.42 $69,551.04 $139,102.08

Others

$3,931.20 $9,828.00 $19,656.00

Lost

$23,889.22 $59,723.04 $119,446.08

d your specific contractual arrangements with your 3rd party payors. The above amounts are for illustration purposes only.

% Medicare Patients

40%

Avg. lost Revenue per patient

$199.08


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Heart 2005A™* User-Friendly Loop Event Recorder for Accurate Documenting of Transient Cardiac Symptoms

Heart 2005A™ *

Heart 2005A is the answer for long-term transtelephonic Simple to use, User-Friendlymonitoring. Loop Event the patient presses a button once symptoms Recorder for Accurate begin in order to record all pre and post ECG Documenting of Transient segments. By pressing the “Transmission” button, theSymptoms patient sends the recorded ECG Cardiac over the telephone to CardiaCall’s Cardiac Receiving Center for immediate diagnosis.

Heart 2005A is the answer for long-term transtelephonic monitoring. Simple to use, the patient presses a button once symptoms begin in order to record all pre > Applications and post ECG segments. By pressing the “Transmission” the patient sends n Detection ofbutton, infrequent symptomatic the recordednECG over the telephone to Post-myocardial infarction arrhythmia n Unexplained pain follow-up Health Complete's Cardiacchest Receiving n Cardiac (ST-Segment analysis)diagnosis. Center for immediate rehabilitation n Arrhythmic therapy monitoring

Applications

• Detection of infrequent symptomatic

>arrhythmia Benefits

•nPost-myocardial Easy-to-use infarction follow-up chestquality pain (ST-Segment analysis) •nUnexplained Superior ECG and rehabilitation • Cardiac baseline stability therapy monitoring Long-term monitoring •nArrhythmic (no time limitation) Benefits n Cost efective Small, portable & convenient •nEasy-to-use

• Superior ECG quality and baseline stability • Long-term monitoring (no time limitation)

> Features

Features

n Single Lead Lead • Single n Non-volatile (Flash) memory • Non-volatile (Flash) memory n 4 events of 30/30 seconds or one event • 4 events of 30/30 seconds or one event

of 180/60 seconds

of 180/60 seconds n One-month battery life battery life • One-month n 4X transmission speed option • 4X transmission speed option *Heart 2005A is a trademark of Aerotel Medical Systems (1988) Ltd.


Heartrak Smart™

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Transtelephonic ECG Patient Activated (symptomatic) & Self Triggering (Automatic) Loop Event Recorder Transtelephonic ECG Patient Activated (symptomatic) & Self Triggering (Automatic) Loop Event Recorder User-friendly loop event recorder for accurate documenting of transient cardiac symptomatic and non-symptomatic events. Heartrak Smart ™ is the answer for long-term transtelephonic monitoring.

> Applications Detection of infrequent symptomatic and asymptomatic arrhythmia n Post-myocardial infarction follow-up n Unexplained chest pain (ST-Segment analysis) n Arrhythmic therapy monitoring n Drug studies n

> Benefits > Features Single Lead n Non-volatile (Flash) memory n 4 events of 30/30 seconds n 14 day battery life (1 “AA”)

Easy-to-use Superior ECG quality and baseline stability Long-term monitoring (no time limitation) Cost effective Small, portable & convenient

n

*Heartrak is a trademark of Mednet Healthcare Technologies, Inc.

> Easy-to-send

Send the recorded ECG over the telephone to CardiaCall’s HeartLine Receiving Station (HRS) for immediate diagnosis.


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You, CardiaCall and Your Patients

You identify the patients with: a) Palpitations b) Syncope c) etc. n

You prescribe an event monitor, establish and review clinical protocols for the monitoring service and provide an interpretation of the results. n Your staff places monitor on patient-onsite and trains the patient for proper use. n Patient uses the monitor for 30 days and calls CardiaCall’s Receiving Center when needed; CardiaCall answers calls on your behalf and responds to you and your patients, based on your standard medical parameters. n You bill code 93268 in accordance with your contractual relationship with your payers. n You pay CardiaCall $99 for a monthly, 24/7 monitoring service. n

> Benefits CardiaCall: n Allows you to have more control over your patient’s monitoring experience; n Provides you and your patient’s with the highest level of remote cardiac event monitoring service and personal care; and n Ensures that you maintain appropriate remuneration with the same or similar level of effort you may have been expending with other event monitoring companies.


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> FAQ’s n Can I bill for the global code for event monitoring?

Yes, with CardiaCall’s Model you can bill the global CPT code for cardiac event monitoring 93268 n What type of monitors does CardiaCall support?

Pre/post loop event monitors Auto trigger monitors Post event monitors n What are the other advantages of using CardiaCall?

Easier patient enrollment Patients always in network No patient back logs Higher physician remuneration n What are the qualifications of CardiaCall Event Monotoring staff?

All of CardiaCall’s monitoring center clinical team members are CCTs or CVTs


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HeartOne™ Pocket Size Transtelephonic ECG Event Recorder/ Transmitter HeartOne is unique in its portability and capability of maximizing patient mobility. This state-of-the-art device does not require electrode cables. It’s so small that it easily fits into a pocket, making it readily available for use at any time, and any place. Patients Pocket Size Transtelephonic simply place thumbs on two designated ECG Event Recorder/Transmitter electrodes and push one button to record a rhythm lead. Recorded results can be transmitted to the CardiaCall’s Receiving Center from any standard telephone.

HeartOne™

HeartOne is unique in its portability and capability of maximizing patient mobility. This state-of-the-art device does not require electrode cables. It’s so small that n Diagnosis of cardiac symptoms it easily fits into a pocket, making it readily n Remote, home/clinic monitoring available for use at any time, and any of chronic heart patients place. Patients simply place two thumbs n Post-myocardial infarction on designated electrodes and push one follow-up • Arrhythmia detection button to record a rhythm lead. Recorded n Pediatric use (with chest results can be transmitted to the Health electrodes) Complete Cardiac Receiving Center from any standard telephone.

>Applications

> Benefits

Applications Diagnostic reliability n Easy-to-record • Diagnosis of cardiac symptoms n Easy-to-send • Remote, home/clinic monitoring of chronic n Pocket-size portability heart patients n

• Post-myocardial infarction follow-up • Arrhythmia detection • Pediatric use (with chest electrodes) *Heart 2005A is a trademark of Aerotel Medical Systems (1988) Ltd.

Benefits

> Features

Features n 2 electrodes (thumb & chest) 2 activation buttons 2 electrodes (thumb & chest) •n n Records and stores up to four • 2 activation buttons 30-second rhythm and stores up tostrips four 30-second • Records Non-volatile rhythm strips memory Low battery light Non-volatile memory •n • Low battery light n


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What else does

CardiaCall Offer? Post-event, Short & Long-Term Monitoring Solutions for transient symptomatic event detection in: n Ischemia (diagnosis, post-surgery/

ablation, post-angioplasty patients) n Anti-arrhythmic drug monitoring (effect and “wash-out”) n Post MI follow-up n Post pacemaker follow-up n Cardiac rehabilitation CardiaCall enables you to provide Concierge Services -- Now your patient can capture their cardiac events by transmitting to us while feeling connected to you and allowing you to offer continued monitoring otherwise unavailable to your patients.

Benefits > Patients n More control of your patients needs while providing superior diagnostic service to your patients and better consultations n Greater patient support, particularly for “high risk” patients n One-on-one immediate assistance 24/7 n Increased patient assurance and peace-of-mind n Eliminates unnecessary ER trips n Fosters excellent patient satisfaction and retention n Provides patient reassurance when necessary > Practice

n Excellent practice marketing

distinguishing your practice from others n More appropriate patient management n Cost-effective - providing an additional source of revenue n Allows considerable reduction in staff and overhead costs n Offers attractive business model


Only A Heartbeat AwaySM

How May I Care For You?

800.220.9511 www.CardiaCall.com 7777 Davie Road Ext. Suite 100, Bldg. A Hollywood, Florida 33024 CardiaCall and the CardiaCall Logo are Trademarks of CardiaCall LLC. TM

PD 2010-03-31

TM

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