Dr. Avi Ishaaya, M.D. Medical Director THE MD HOME SLEEP PROGRAM

Introduction to the MD Home Sleep Program Aviisha Medical Institute, LLC | The MD Home Sleep Program Overview The Concept Behind the MD Home Sleep Program How MDHSP Works (4 Stages) Patients Accepted Getting Started Q&A

Introduction to the MD Home Sleep Program Aviisha Medical Institute, LLC | The MD Home Sleep Program Background 1 out of 8 Americans suffers from for sleep apnea 24% of middle age men and 9% of middle age women are at high risk for OSA Highly correlated with obesity (70%) 93% of women and 82% of men with moderate to severe OSA are undiagnosed and need treatment 38 million Americans are currently undiagnosed and should be tested for OSA Conclusion: There is a strong need to make physicians aware of the ongoing sleep apnea epidemic and give them the tools to treat it “in-house.”

Introduction to the MD Home Sleep Program Aviisha Medical Institute, LLC | The MD Home Sleep Program Objectives The MD Home Sleep Program aims to: Give physicians the tools to identify, diagnose, and treat OSA so they can treat more patients Streamline the process as much as possible by: 1. Avoiding expensive and uncomfortable lab visits by using home sleep tests and state-of-the-art APAPs 2. Using technology to simplify diagnosis and treatment 3. Absorbing logistical responsibilities—shipping, billing, technical issues, scoring, interpreting, collecting—so physicians can focus on medicine and earn revenue

Introduction to the MD Home Sleep Program Aviisha Medical Institute, LLC | The MD Home Sleep Program 4 Stages of MDHSP

Introduction to the MD Home Sleep Program Aviisha Medical Institute, LLC | The MD Home Sleep Program Stage 1: MD Sign Up & Activation MD registers through /mdhsp or our national partner Merritt Hawkins through /mhamdhsp /mdhsp /mhamdhsp MD ed link to Participation Agreements (can be signed online) MD sent screening tools and HST Lease Agreement (for patients)

Introduction to the MD Home Sleep Program Aviisha Medical Institute, LLC | The MD Home Sleep Program A Closer Look at the Screening Tools and Lease Agreement

Introduction to the MD Home Sleep Program Aviisha Medical Institute, LLC | The MD Home Sleep Program Stage 2: Evaluation Patient completes P ATIENT M EDICAL I NFORMATION form at clinic pre- evaluation MD evaluates patient using completed P ATIENT M EDICAL I NFORMATION form (and OSA S YMPTOMS G UIDE ) MD generates prescription for HST using smartphone or computer (patient’s first and last names only); clinic ed link to complete order information online Patient signs HST L EASE A GREEMENT at the clinic. The agreement and medical info form are uploaded or faxed to Aviisha

Introduction to the MD Home Sleep Program Aviisha Medical Institute, LLC | The MD Home Sleep Program Stage 3: Diagnosis Aviisha ships, bills, and administers the entire HST on MD’s behalf Results and recommendations shared with MD MD prescribes APAP online; clinic completes order online Patient ed link to F INANCIAL A UTHORIZATION A GREEMENT and mandatory training video Shipping Scoring Interpreting Billing/collecting Diagnosis recommendation Support from 7:30am - Midnight PST

Introduction to the MD Home Sleep Program Aviisha Medical Institute, LLC | The MD Home Sleep Program Stage 4: Treatment & Compliance Aviisha Medical Institute, LLC | Aviisha.com APAP shipped to patient’s home; insurance billed when applicable APAP connected to Aviisha compliance system via modem; Aviisha manages treatment compliance and generates progress reports; APAP records data on SD card in case modem unavailable Progress reports shared with MD; MD bills for compliance

Introduction to the MD Home Sleep Program Aviisha Medical Institute, LLC | The MD Home Sleep Program Key Features MD can choose to bill on their own or have Aviisha bill the insurance on their behalf (for out-of-network) MDs primary duty is to evaluate for OSA; the rest of the process is handled by Aviisha, but MD still earns income as the prescribing provider No cost, investment, or expense to MD

Introduction to the MD Home Sleep Program Aviisha Medical Institute, LLC | The MD Home Sleep Program Which patients are accepted? In-network & Out-of-network* MD reimbursement may vary by state, insurance plan, and insurance company Medicare HST only MD receives sleep test detailing scoring results; MD interprets the test and bills for professional component; Aviisha’s sleep-boarded doctor reviews MD’s diagnosis Cash Uninsured, high deductible or out-of-network deposit can all be financed starting June 2011 (approximately) * Aviisha-Bill available

Introduction to the MD Home Sleep Program Aviisha Medical Institute, LLC | The MD Home Sleep Program MD Possible Reimbursement Reimbursement schedules vary by state, insurance plan, and insurance company Anticipated monthly prescription rate per physician HST: 10-15/month APAP: 4-7/month

Introduction to the MD Home Sleep Program Aviisha Medical Institute, LLC | The MD Home Sleep Program Getting Started To sign up or learn more about the MD Home Sleep Program: Call an MDHSP administrator at or contact Taylor Bonham from Merritt Hawkins at Get set up and trained to evaluate and prescribe Access our OSA newsletter, screening tools, and OSA webinars

Questions? Contact an MDHSP Administrator: (877) Oxnard St. Suite 413 Tarzana, CA More webinars available at: