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Recording of Teleconference from November 2019
Dr. Pearlberg, MD

Dr. Pearlberg is a retired Ophthalmologist who within his first 12 months closed over 12 medical practices. This interview provides reps an opportunity to better understand the appeal of the technology from someone who is both a doctor and a successful sales rep. It should be noted that Dr. Pearlberg does not see himself as a sales rep but instead a medical professional bringing advanced technology to doctors. Because of his relationships with Ken and Tara, he relies on them to do the closing.


Ken: I have Dr. Kenneth Pearlberg on the phone. He has been a close family friend for many many years. We could really spend probably an hour just talking about his credentials. Medical School was State University in New York and Domestic Medical Center, Brooklyn, internship Brooklyn, Residency, State of New York Manhattan, Ear, Nose and Throat, Diplomat, Certified and recertified by the American Board of OPthamalogy and American College of Surgeons.

He is an amazing doctor and he really cares about people and his patients and is a very straight shooter which is not normally found in our part of the country. We are honored to work with him. He also does much work with big corporations and has a keen instinct to get to the decision-makers. He is a world-renowned ophthalmologist. Thank you doc for being on the call. We’re going to turn the call over Diana.

Diana: I want to thank you and all the people on the call. I know that Tara was able to give you the questions ahead of time so if you’re ready we are.

What piqued your interest in becoming a sales rep for Pulse 4 Pulse?

Doc: Actually it was the medical part. I am the senior medical advisor for Pulse 4 PUlse. I”m not the business contact. I do anything that has to do with the medical part. What piqued my interest is when Ken first approached me and told me about this corporation I researched what they’re doing. I researched their technology and it was good timing because my wife had some medical issues. She had something which bothered me which was based on a vascular issue so I was already looking at different testing for my own family for different things I was concerned about. Fortunately, they turned out to be fine. But it piqued my interest in the entire industry of vascular testing.

I am into a lot of different technologies in medicine. This one was always interesting to me so I researched it further so then when Ken said it had an excellent business model that was the icing on the cake because I was only originally interested in the medical part.

What specialties have been most receptive to this business? And What buzz words would best get at an office manager or physician?

Without a doubt, the best practices are internal medicine and primary care and family practice. Those are your best for sure. Forget about the rest you have down here like OBGYN, Podiatrist, and anti-aging. Those are 2nd and 3rd tiers. The first tier is internal medicine, family practice, and primary care period.

The 2nd tier would be is chronic pain management. The problem with chronic pain management is you have a lot of cash-based practices. Many chronic pain practices, unless they are extremely sophisticated, and doing a lot of different things, they are more interested in the cash part of the business.

So I understand and I don’t have any inside knowledge on this but I understand that there is an incentive program for cash-paying from Pulse 4 Pulse . I’m not saying you can’t talk to them. I have talked to them. In fact, one of my first accounts was that I helped Kenny and Tara with a chronic pain management practice.

And I have more now with that. So I’m not saying that it’s something you can’t do. You can do it. But what I”m saying is that when you talk to these practices such as an internist, and primary care it’s really a no-brainer.

The problem with these internal medicines and primary care practices is you have to make sure they are convinced that the billing is very very accurate, very ethical, which it is. Pulse 4 Pulse is doing a great job on that.

But you’ll find that a lot of your customers are going to love the fact that you’re going to do the billing for them and an equal amount will dislike intensely the fact that you’re offering them the billing. They want to keep the billing to themselves which I understand from Kenny and Tara that that is not a problem. You can do it either way.

When you approach these practices and tell them “I got great news for you, we do all the billing” when in fact that turns out to be something that they don’t want. So you got to play it both ways.

The way I do that is if they ask me I always refer them to Ken and Tara because they are the business experts, not me. When they pin me down to say “how does the billing doc?” I say it can be worked out at your convenience where Pulse 4 Pulse has expertise in this area. They get better reimbursements because of their expertise. Their people are better oriented because of this field and probably they will be better at it than your people in your office, but you have the option of going either way.

So that’s how I answer them so I don’t turn them off. I try to let them know that they will be better off letting P4P do the billing.

Does Pulse 4 Pulse service apply to ophthalmology?

I don’t know why this question came up. Opthalmology is a complicated specialty. A lot of ophthalmologists already have some form of testing done in their offices like allergy, or transcranial doppler which is bigger money for them, than what we are offering. A lot of them are already in that. It’s bigger but money, but it is also a bigger headache for them.

So everything has its plus and minuses. I have no problems going to Ophthalmologists. But that is the problem I”m coming up with. They already have allergy testing and transdopler testing which is not the same as doing peripheral arterial disease screening. But it does come up. I can’t really answer you regarding Ophthalmologists. It’s hit or miss. IF they are very business-minded they may like it otherwise they won’t like it. The other thing with Otphamologists they don’t like getting involved with the follow-up. They like doing one time deals. So I tell them that we have the ability to contact the patient’s primary care physician. A lot of this the Opthomologist is busy and doesn’t want to be bothered with anything else. It’s hit or miss with ophthalmology.

What approach do you recommend approaching an office manager of a physician?

What I recommend is you tell them that you have something very good for their patients. We have physicians using it and we have a medical advisor who would be happy to explain this to your physicians. We have a good product, good for patients, and very very good for increasing your practice revenue.

It’s 100% approved and accepted by the medical community and we have no issues with Stark laws. That’s the way I would introduce yourself. You’re showing that this is something of value, there are no issues with Stark. you have the medical evidence to substantiate what you’re talking to them about. You have a doctor that is willing to talk to their doctor. Without being overly aggressive I think that is the way to start.

What objections have you come across?

I already told you one of the objections regarding the billing. Let me tell you a little more about what I mean. I am not a biller, and I have nothing to do with the codes. I know that P4P is doing it completely correctly and using the right codes and bundling them together. Having said that I”m running into a problem right now with a very large practice where the one that is in charge of the billing is raising issues around the fact that in the state of Florida you have to be very careful how you bill.

There are certain constraints regarding Medicare. You’re going to run into people that think they have expertise in this. I don’t know if they have as much expertise as P4P. But at least they think they have the expertise. They give you objections about billing it. In some cases, the doctor will say because of STARK laws you have to rent separate space and then I understand from P4P that it is completely contrary according to start regulations.

My point here is you’re going to encounter people who are not as knowledgeable as P4P. And you’re going to have to walk a fine line where you don’t insult them and tell them they don’t know what they are talking about. What you tell them is that we have expertise in this area and that we are dealing with practices with almost every specialty across the country and this is what we do.

And get our coding experts to call them to listen to their concerns. I open the door medically and then I allow Ken and Tara to take it from them.

I never try to make them think that I am someone to answer their business questions. I always defer them to people that are better at it than me like Ken and Tara. That way there is no conflict of interest so that if I say something, or they say I said something it can be taken the wrong way. So rather than putting myself in a position where I would be told I made a mistake I prefer to keep the business part totally out of my discussion.

How long have you been with P4P?
I’ve been with P4P since the beginning of last year (2018)

How many practices have you brought on board?
Somewhere around 11 or 12. I have a whole bunch which are pending right now.

What is the longest time it took to close?
About 9 months ago I started getting really good responses.

What has been your experience with the implementation team?
I think they’re excellent. Once they get the go-ahead, they get right in there. They address the situation. They make sure that the MA’s that they hire, in my experience at least, have been acceptable to the clients. They make sure the doctor offices like the people.

Most of these practices have multiple offices with multiple physicians involved. It’s very few practices with a single physician or a single doctor running a single office. In almost all of these are multiple offices and multiple physicians.

And you are aware that the nurse practitioners and the physician’s assistants are able to be involved in this program. A lot of times they’re more productive than the physicians because physicians are used more in a reference roll in the practice. In other words, you have a PA or an NP working up the patients and the doctor is in the background. It’s the PA and NP who are hustling.

Having said that according to what I”ve been told by P4P, if the PA or NP sees the patient and the testing is done while the physician is present then I believe that we can still bill it under the physicians NPI. If the PA or NP’s are doing it when the physicians are not present then it’s still legal but at a reduced rate. Is that accurate Kenny?

Tara: Yes, but we’re researching a number that physicians could supervise from a distance. We don’t know yet the answer to that.

[Answer: If the MD is not present or on-site then the tests are billed under the NPs or PAs NPI at a 85% reimbursement rate.]

Do you use any marketing tools?

I do everything through email. I don’t give anybody pamphlets. I”m not in sales. I think that would be perceived in the wrong manner [since I approach them as a physician]. But what I do is send in information about medical studies to back indications in their specialty. It’s widely accepted that this kind of testing is very helpful in the diagnosis of peripheral arterial disease. When you’re dealing with PAD there are no symptoms until the 60% narrowing of the [blood] vessels. At least 20% of the people over 60 have PAD .

Do you mention the referral program?
Yes. I tell them there is a referral program. I tell them that there is an opportunity for them to do very well for their patients and make a lot of additional income, even more so if they recommend colleagues.

Having said that, you and I should share the same message‚Ķ”Dear Doctor, I’m coming to you with something that is going to help your patients, a vast majority of them are undiagnosed. They’ll say, we already refer out to testing when it’s needed.” And I say, that’s the whole beauty of what Pulse 4 Pulse is doing. We are screening asymptomatic patients That’s the keyword! Screening in asymptomatic patients! You’ve got to remember that word.

The cardiologists will say “oh, we have our vascular surgeons, we have our vascular people whom we refer.” I say, “I want you to do that. We’re not replacing your referrals, we’re enhancing your referrals! We’re picking up the ones you’re not picking up! You’re not seeing these people because they’re asymptomatic.

So if they have the indications. If they have high blood pressure or high cholesterol, or if they have erectile dysfunction or heart disease, smokers automatically qualify for having this testing done. And they may be 100% asymptomatic.

Let’s put it right on the square here. A significant proportion of them are going to be found to have PAD which no one was aware of. So you’re doing to the patient and the practice an excellent favor here. And that is the thrust of everything I do. It’s great for your patients, it’s great for your practice. You’re picking up the asymptomatic people that they are not picking up. This is very instructive. It’s true. It’s accurate and it really summarizes the whole thing. Because I”m always getting this thrown back at me, “we have our own people.”

Diana: We’ll that was just fabulous. I can’t thank you enough. I’m sure I”m speaking for everyone. Everybody now has just a renewed intensity and excitement about being a part of this burgeoning business. May I ask one more question?

Is this business model new?
I researched this when I started. There is a machine out called “Quantuum Flow” which many practices and large corporations have. It’s fancier and quick but doesn’t offer the same kind of information that the testing that Pulse 4 Pulse does.

There are many types of equipment programs out there. What stands out the most, in my opinion, you have the equipment being placed in the office, free of charge, the medical techs being placed, in the office free of charge, the billing is being offered free of charge.

You have expertise in this one area. They guarantee results within 24hours and they get to follow up visits that are approved by Medicare and the commercial carriers. And you have the expertise of someone who is board certified in the specialty and who is reviewing the testing so that when the doctor sees the patient they are receiving detailed analysis from the equipment with details of the condition in a 14-page report and a summary with recommendations for the physicians on follow up steps. I”m not aware of anyone else doing that. The “Quantum Flow” and the other equipment do a superficial screening test.

Let me give you an example. As an ophthalmologist I often get patients referred from optometrists and they’ll send me something like a recommendation to treat the patient for glaucoma or treatment for a disease. What happens is that the optometrist sends me a certain study to show me what they did. There is nothing wrong with that. But once that happens, as a specialist, I have to redo all the studies what they did, but with much more sophistication What I’m getting at is that the other equipment like Quantuum Flow give you an introduction but there is no in-depth detail like what you’re getting with Pulse 4 Pulse.

Diana: Thank you.

Tara: Thank you Dr. Pearlberg. You did a great job.