More than half to 50 million 5th 3rd

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Hector Higgins
5 years ago
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2 Did you know? More than half (54.6%) of all U.S. citizens test positive to one or more allergens. Allergic diseases affect as many as 40 to 50 million Americans, including asthma and bronchitis. Allergies are the 5 th leading chronic disease in the U.S. among all ages and the 3 rd most common chronic disease among children under 18 years old.

3 Treating Symptoms vs. Cause Most common treatments (OTC and prescription medications) aid only in lessening allergy symptoms not treating the cause. This essentially means patients can expect being medicated for life. When given an educated choice, most patients would prefer to get rid of their allergy symptoms permanently wouldn t you?,

4 What s wrong with a little stuffy nose? Allergies due to Allergic Rhinitis can have some serious repercussions. Allergies limit activities for 40% of children. Allergies are the 3 rd largest reason to miss work, accounting for 4 million missed or lost workdays each year and $700 million in lost productivity. 40,000 people have sinus surgery every year most of these people never knew there is another option that may have prevented this surgery.

5 So what s the solution?

6 Immunotherapy Immunotherapy utilizes the results of a scratch test that determines what a patient is allergic to. With these results, a custom serum is made to be injected over a period of time to build up the patient s immune system to the offending allergens. Think of it like a vaccine.

7 Immunotherapy Immunotherapy is a form of biologic therapy or biotherapy (sometimes also called desensitization or provocation neutralization). It stimulates your own immune system to work harder or smarter. Immunotherapy is administered subcutaneously under the direct supervision of the physician. Immunotherapy helps reduce hay fever symptoms in about 85% of people with allergic rhini9s

8 How long does it take to work? Most patients begin to experience symptom relief in the first 60 days of treatment. One round of the program is 12 months. Depending on the patient and their response to Immunotherapy, treatment may be up to 3 5 years.

9 What does our Allergy Solution Test for? It tests for the 70 most common geographically specific environmental allergens in the practice location, plus dog and cat dander. Examples are: Dust mites Tree extracts Grass extracts Weed extracts Common Foods Pollen

10 Who can be tested for allergies? Adults and children over the age of two Patients with asthma, allergic pneumonia, conjunctivitis, cough, dermatitis, some insect allergies, rhinitis, sinusitis, urticaria and angioedema. Any patient, that at the worst time of year (seasonal) would rate their allergies a 3 on a scale of 1 to 10. Any patient currently receiving medication to mask these symptoms and wants the opportunity to rid their allergies.

Patient Screening Who cannot be tested? Our recommended patient selection exclude patients with: History of severe anaphylactic reactions to the allergens we test for.

11 Patient Screening Who cannot be tested? Our recommended patient selection exclude patients with: History of severe anaphylactic reactions to the allergens we test for. For these patients, RAST tests may be safer. Patients that are severe asthmatics and some moderate asthmatics that are unmanaged by medications. Patients on Beta-Blockers or Ace Inhibitors. Pregnant or Breast feeding female patients.

12 Wait to test if Patients must be off the following medications for 72 hours prior to testing to ensure the most accurate results: Antihistamines Steroids Antibiotics If the patient already meets these criterion and has the time, the Allergy Test may be performed immediately.

13 Test time! After all paperwork is completed, the trained Clinical Lab Specialist will perform the Allergy Scratch Test if the patient has been off all medications that will affect test results. Once the test has been applied, results take between minutes to read. The CLS will then measure the results, record, and the physician will discuss the results with the pa9ent.

14 About our Allergy Lab Solution We are a medical service company specializing in setting up fully operational allergy testing and therapy labs in existing medical practices. We partner with your medical practice to provide a new valuable patient service. We creates a new revenue stream that was previously lost through referral or limited to prescriptions and simple office visit fees. We offer 2 op9ons in servicing your prac9ce: Op9on A: Trains members of your staff on services. Op9on B: Provides trained Medical staff to administer our allergy services in your prac9ce.

Operating Model Will assist in implemen9ng a lab in your prac9ce in a 150-300 square foot area that will refrigerate raw an9gens, store finished pa9ent product, ensure compounding area, and space to

15 Operating Model Will assist in implemen9ng a lab in your prac9ce in a square foot area that will refrigerate raw an9gens, store finished pa9ent product, ensure compounding area, and space to educate pa9ents away from flow of current prac9ce. Will assign a highly trained Implementa9on Team to assist your prac9ce in either Op9on in understanding lab du9es, required paperwork, and handle pa9ent educa9on and scheduling of therapy. Will provide most office equipment and supplies, tes9ng and therapy supplies, and necessary educa9on materials. Will support your back office to complete billing cycles and help ensure your physician group receives collec9ons. All services are provided at a fair market value.

16 Billing & Collections

17 Once you identify a candidate for Allergy Testing and/or Immunotherapy, the next step is to verify the patient s insurance. We can provide a separate form for this with the appropriate codes to verify, or they can be incorporated to your clinic s existing verification forms. Most insurance carriers, including Medicare and Medicaid, accept billing for the codes utilized in the Allergy Program. Patient Screening Next Step

18 Recommended Billing Procedures - Immunotherapy **Once determined from the test results the following ICD-10 Codes are further recommended for ensured payment. J30.9 Allergic rhinitis due to pollen J32.9 Sinusitis H10.45 Allergic Conjunctivitis L23.9 Allergic Contact Dermatitis

Recommended Billing Procedures The Practice Group is responsible for the billing of all insurance claims for Allergy Tests and Immunotherapy.

19 Recommended Billing Procedures The Practice Group is responsible for the billing of all insurance claims for Allergy Tests and Immunotherapy. LabPharm is not responsible for E&M coding and determinations. We can only recommend how to bill for Allergy Testing and Immunotherapy Services.

20 Reimbursements Reimbursement for allergy testing averages from $250 to $450 per patent for all types of insurances. Average Reimbursement for Immunotherapy varies: BC/BS = $1,300 United Health Care = $1,750 Aetna = $1,760 Cigna = $1,774 Tricare = $1,620 Medicaid = $1,511 Medicare = $1,280

21 Assumptions for Projection Model Single physician clinic who sees 40 patients / day 5% are tested (2 tested) 80% are appropriate for immunotherapy (> 1 test positive) 50% elect Immunotherapy (1 ) Typical practice insurance mix of: 60% private mix of carriers average $2,600 20% Medicare carrier $1,500 20% Tricare, Medicaid, cash average $1,600 This model is based on ONE PATIENT per business day.

How to get started Email completed physician enrollment form to ANCservices@labp harmllc.

22 How to get started completed physician enrollment form to harmllc.com LabPharm LLC performs a prac9ce analysis to ensure your prac9ce would be well-suited for a LabPharm Allergy lab Review and sign LabPharm LLC Contracts and clinic set up documenta9on Our Allergy Lab Solu9on implementa9on (typically 3-4 weeks post-signature). This allows us +me to train your specialist, in your office, order and ship lab supplies and marke+ng tools.

23 Conclusion In Partnering with our Allergy Lab Solution, you will: Provide a higher level of service to your patients Retain a percentage of your patient population, which you could not treat in the past Offer a new service without increasing your operating costs or additional staffing Recognize a brand new revenue stream

West Houston Allergy & Asthma, P.A.

West Houston Allergy & Asthma, P.A. Consent to Receive Immunotherapy (ALLERGY SHOTS) Procedure Allergy injections are usually started at a very low dose. This dose is gradually increased on a regular (usually 1-2 times per week) basis until