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(other than the $85,000 to $143,000 average increase in annual net income to primary care physicians, and increase of more than $160,000 per year to cardiologists?)




But � you may or may not need it, depending on your patients, your insurance mix, your specialty and whether you are willing to learn about ways to improve medical outcomes.We�re very serious about wanting to learn, as occasionally, we run into doctors who are NOT willing to admit what they do not know about the autonomic system and how it interacts with the endocrine system and the effects they have on the patient which chronic conditions.�� For those that are wanting to learn how this technology that has been accepted by the AAN, ADA, AHA, AAFP, Juvenile Diabetes Association, National Heart, Lung and Blood Institute, and the National Diabetes, Digestive and Kidney Diseases, this may help you help your patients.

Check out this Powerpoint Presentation that explains WHY Medicare, the NIH, the AAN, ADA, AHA and others recommend this as standard of care: NOTE that as of January 1, 2013, there are CPT CODE CHANGES. IN 2013, we are recommending you use CPT code 95943. We do NOT know how much Medicare's allowed will be on that code, as it is not on the MPFS because CMS did not get the RVU amounts in time to be published in the November 2012 Federal Register. Therefore, while it IS payable by Medicare, it is classified as status "C" for contractor pricing. This means that the individual MACs and contractors will determine the allowed amount price in their own localities. Once we get data from all of our Ansar clients around the country (people who have bought Ansars from Don Self), I will update this page as well as the monthly newsletter that we publish each month with the payment data.



The Ansar is a device that uses a blood pressure cuff, 3 lead EKG, computer and an algorithm software developed by Harvard and MIT to perform heart rate variability in association with respiration variability to detect Autonomic Nervous System dysfunctions and imbalances.Just ONE of the benefits is that this test is able to tell the doctor whether a patient with CHF has too many beta-blockers or not enough on board.��Keeping in mind that the American College of Cardiology says that 30% of patients with CHF have TOO-MANY beta blockers on board, this test becomes invaluable.The test is effective with diabetes, hypertension, syncope, CHF, Orthostatic Hypotension, Sleep Apnea, and a lot more.



If you see CHF patients, you have some of them that are fatigued, malaise, having sleep difficulty and have probably lost all interest in sexual relations with their spouse.They probably stopped going to church, to visit friends, to visit family, shopping, etc� and if you�re NOT checking the dosage of the beta blockers (regardless if you�re the family doctor, Internist or cardiologist), are you REALLY giving them the best care?�� Are you giving them the care you would want your mother or father to get?If not � then, in our opinion, you should be looking at the ANS on your patient.


Now � we said at the top, that this may or may not be right for you.��� If you have a practice that is 80% capitated, then this isn�t right for you because you�re most likely not going to take 25 minutes of your nurse�s time to do a test on a patient � knowing that you will not get one penny more than the cap rate of $15 or whatever you get, per month on that patient.�� Only 1 in 200 doctors will do that, and especially in today�s recession.


Now, we do have a client very near Philadelphia, that has 50% capitation, and after examining his patient base, number of patients with the top 5 chronic diagnosis that ANSAR helps the most, he is using it on his patients and he tells us that not only has he increased his monthly income by more than $25,000 per month, he has saved at least 4 lives with it that he probably would have lost had he not been doing ANSARs.Yes � some doctors call this �anecdotal� until the subject of the anecdote is their own family member whose life was saved or their lifestyle improved and then they actually believe it can actually help people.(Yep � I�ve been doing Ansars for going on 9 years and been working with physicians for 25).


We have several physicians that have told us (and given us letters to share) that they have had the patient�s cardiologist tell them they were surprised that a primary care physician captured emergent problems on asymptomatic patients and saved their lives.


So � why are most of the doctors we�re selling ANSARS to in the Family Practice, Internal Medicine or Geriatric specialties?�� These specialties are the ones seeing 18 to 30 patients a day with the top 5 chronic diagnosis.These doctors are seeing patients with diabetes, hypertension, CHF, sleep difficulties and pain.�� They know that 22% of asymptomatic diabetics are experiencing silent ischemia (even though the patient doesn�t know it) and they want to detect ANS dysfunctions BEFORE it leads to Diabetic Autonomic Neuropathy or Cardiac Autonomic Neuropathy.�� If you�re a patient � don�t YOU want your physician to capture something before it gets to where they can only �monitor� it?��� If you capture ANS dysfunction early enough � you can make a difference in the patient�s life and their prognosis.If you wait until you have neuropathy � then the nerves are dead and they don�t come back � so which one makes more sense?


Yes, sometimes we sell them to Cardiologists who really want to make a difference with their patients and who really care whether their CHF patients are over beta blocked or not.�� These doctors are monitoring for and titrating for Paradoxical Parasympathetic Syndrome and they are saving lives.


What other test do physicians have in their office that will tell whether the patient has any sympathetic or parasympathetic protection?



We are educating the physician willing to learn and willing to admit that maybe something can help their patients with ANSARs.


Do all of our clients need an ANSAR?�� No � but in 9 years we haven�t put an ANSAR into a Family Practice clinic where the physician did not appreciate what it was doing for their patients.�� Not one.��� In 9 years, we have not put an ANSAR in an Internal Medicine practice where the doctor did not later tell us it helped save at least 1 life.�� Not one.


Autonomic Nervous System Monitoring is recommended as a Standard of Care by the AAN, ADA, AHA, AAFP, Juvenile Diabetes Association, National Heart, Lung and Blood Institute, and the National Diabetes, Digestive and Kidney Diseases.


Are you not as familiar with the Autonomic Nervous System as you would like to be?Check out this Powerpoint Presentation that explains WHY Medicare, the NIH, the AAN, ADA, AHA and others recommend this as standard of care:



At the end of it, you can click on a link for a pdf of the presentation as well, so you can show it to your colleagues, manager, physician, etc�



So � let�s look at some specific diagnosis:


Why ANS monitoring in Diabetes?


Diabetic patients Parasympathetic and Sympathetic systems are both out of balance. Each patient is metabolically different; therefore, there is no one example that best explains a �common situation� for Diabetes. The one thing that is a constant is an imbalance.The more out of balance the Parasympathetic and Sympathetic is, the faster the disease will progress and the less effective the medication is that you�re giving the patient. The physician, after identifying the severity of the autonomic imbalance with the ANX 3.0, would then customize a treatment plan to bring both branches into balance.


Why ANS monitoring in Hypertension?

Parasympathetic tone is low and Sympathetic tone is high in Hypertensive patients. Once the physician reduces sympathetic-blockers they can lower Sympathetic tone and bring the two branches closer to balance. Another situation that arises is Autonomic Hypertension. In this case, Parasympathetic tone is high and the Sympathetic tone is abnormally or exceptionally high, which indicates PPS. The physician would need to treat the Parasympathetic tone and then they would be able to correctly treat the Sympathetic tone and restore balance.


Why ANS monitoring in Orthostatic Hypotension?


During the postural change the Parasympathetic tone abnormally increases and/or the Sympathetic tone abnormally decreases in patients with Orthostatic Hypotension. Physician must correct abnormality to resolve Orthostatic Hypotension. ��The 3rd PQRI (Physician Quality Reporting Initiative) calls for physicians to perform Orthostatic Blood Pressures, yet (in our experience), less than 5% of the primary care physicians do this.This means that it is OBVIOUS that most physicians are NOT capturing, monitoring or treating the Orthostatic Hypotension or Orthostatic Intolerance Syndromes.���� This is NOT good medicine when you consider the fact that Orthostatic Intolerance Syndromes are the Most Common Cause of Syncope (American College of Cardiology -2007)

Why ANS monitoring in Cardiovascular Autonomic Neuropathy?


Both the Parasympathetic and Sympathetic tone are low in patients with Cardiovascular Autonomic Neuropathy. The physician would manage drugs to increase relative Parasympathetic tone to preserve longevity and quality of life. If the relative Sympathetic tone is low but still much higher than Parasympathetic tone, the patient is in risk of sudden death.



Why ANS monitoring in Syncope?


Peak Sympathetic response to postural change approximately the same or higher than peak response to valsava is associated with syncope in young people. Too much response Parasympathetic response through out the test is associated with syncope with older people. Physician would then customize therapy.

Why ANS monitoring in Sleep Apnea?


It is known that with sleep apnea the Sympathetics are exceedingly high and the Parasympathetics are low normal to low.So much so that the natural inversion that should take place in the evening fails.The high Sympathetics (due to the stresses of sleep apnea), prevent the inversion and thereby prevent proper sleep.CPAP helps to remove some of the stressors that are associated with sleep apnea and over time the Sympathetics decrease and the Parasympathetics normalize.ANS monitoring can document this and, thus, document CPAP compliance.


Why ANS monitoring in Pediatric and Geriatric Diseases?


In Geriatric Diseases both the Parasympathetic and Sympathetic tone are depleted due to age in addition to the disease. Low normal balance (Slightly elevated parasympathetic tone) preserves quality of life and longevity.


In Pediatrics diseases Parasympathetic tone is excessive. Physician would use a low dose, short term, anti-cholinergic. (String of disorders include: ADD, Depression, Anxiety, Bipolar Disorder, and Sleep Problems)

It is the standard of care by many associations, hospitals and groups.��


If a patient is tested and determined that a modification to the treatment or therapy (such as an increase in the Coreg, reduction in the Toprol, starting the patient on Midodrine or ProAmitine, increasing their water to treat the dehydration, etc�) is called for, then the patient should be tested in 8 weeks as it takes about 6-7 weeks to make a noticeable change in the ANS.���

The CMS website does not have a Medicare Limited Coverage Decision on any other state than California, so the diagnosis is not limited by Medicare in any state other than California.

The average Medicare allowed is $152.00.Your locality may be a little higher or lower, depending on the Medicare allowed.�� Private and commercial insurances usually pay the doctor between $175 and $265, with the exception of those in the 5 states where the doctors have signed contracts for below Medicare rates (PA, OH, NY, NJ, MD and the Orlando area of Florida)

Almost every single primary care practice we have sold an ANSAR to over the past 6 years tests between 3 and 4 patients a day � PER PROVIDER. ��Some of our practices with mid levels and multiple physicians are testing between 10 and 12 patients a day.What does this do to your income? ��

WHICH CARRIERS PAY?The ONLY carrier that I have seen any problems with payment in this country is the Alabama Blue Cross.I have never seen any denials from any other carrier and I started selling this over 10 years ago.

RECOMMENDATIONS:I have physicians around the country that recommend this to their colleagues.Some have been using it for more than 5 years and some have only been using it a month or less.It would be my pleasure to provide anyone with some phone numbers and names of physicians, if your physician is truly interested in talking to others.

We also have hundreds of EOBs from all kinds of carriers, from most parts of the country and we�ll be glad to send those to you � including Medicare EOBs.Of course, the patient�s name and HIC number is removed from the EOB, but the rest of the information is there and in most cases, the name of the doctor as well.Our clients are happy to tell others about what it has done to save the lives of their patients as well as what it has done to the financial health of their practice.


More of value to you is that we will take an hour on the phone with you � at no charge � to help you determine if you even need an ANSAR.��� You may or you may not, and that is why we are willing to talk to you about this over the phone at your convenience

Don Self



903 372-7529