Doug Rafferty Senior Consultant/Pacific Region Immuno Laboratories 800-231-9197 Ext: 6414

1. Doug Rafferty Senior Consultant/Pacific Region Immuno Laboratories 800-231-9197 Ext: 6414 DougR@immunolabs.com

2. Physician Training Where do you start? Lets start at the beginning

3. Symptom Check Sheet • Have patient complete “Symptom Check Sheet” • Attach completed check sheet to patient history for doctor’s review

4. Doctor’s Exam • Doctor reviews “Symptom Check Sheet” along with patient history and current symptoms • Using “Physician’s Test Indicator Guide,” doctor selects appropriate food allergy tests for patient • Doctor completes requisition form • By indicating which tests/assays he/she would like ordered • If covered by insurance, doctor indicates up to 3 ICD-9 codes describing patient’s symptoms

5. Phy Test Indicator Guide

6. Req Form

7. Completing the Req form • Complete patient information section of requisition form. (This can be done by either patient or staff. Office staff MUST verify form is completed accurately. • Be sure to mark the Medicare box, as required by law. If Medicare is primary, NO IgE assays or assays with asterisk marked next to them can be run by Immuno labs. Not even if paid by cash.

8. Req Form Front Section 1

9. Req Form Front Section 2

10. Req Form Front Section 3 Complete payment section by marked the appropriate box. If patient pay, Pt must complete CC info and sign. Req will not be processed without proper payment.

11. Insurance Coverage • If insurance is being utilized, the back page of requisition form must be completed • Have patient complete the top portion with all necessary insurance information. • Copy front and back of patient’s insurance card and attach to requisition form. • The insurance authorization MUST be signed otherwise insurance cannot be verified or billed. • Immuno Lab’s does not bill United Healthcare or Medicare. Any patients covered by either of these insurance plans must be considered pt or phy pay. • Immuno Labs will verify coverage after they have received the sample and a completed /signed req. form. • Immuno’s insurance department will call pt and explain benefits and costs. Pt can choose at that time to proceed with insurance billing or change to Pt Pay and provide CC.

12. Req Form Back Section 1

13. Req Form Back Section 2 ICD-9 Codes provided by testing doctor

14. Req Form Back Section 3 MUST BE SIGNED BY PATIENT!!

15. The Blood Draw Kit

16. The Blood Draw • Provide patient with draw kit and completed requisition form with recommendation for local draw station. (It is recommended patient receives an address and map). • Explain to patient that draw kit and requisition form are to be given to draw station. Draw station will complete blood draw and send kit to Immuno Labs via prepaid FedEx. • Or draw patient’s blood in your office as described in draw kit instructions.

17. What the patient will receive

18. What to point out The Wallet Card. Should be carried with pt at all times. This will help when shopping and when dinning out.

19. Results The positive foods are marked in red and graded 1+ to 4+. It is recommend that all + foods are eliminated. Immuno will use the good foods shown in blue to created the rotation diet.

20. Rotation Diet Plan The good foods are used to create a 4 or 2 day rotation diet plan. The plan can be customized by the patient on-line at BHUSA. Pt should also remove any IgE foods they know of or foods not recommended by the doctor.

21. Review Results • Doctor will receive results within 7 to 10 days. • Doctor reviews results with patient • It is recommended that the doctor or a member of his staff explain the Immuno Health Guide and DVD’s to the patient and recommend the patient read the Immuno Health Guide and watch the DVD’s prior to asking questions. Most questions are answered on the DVD’s. • Be sure to point out the 4-symptom check sheets and food journal in the back of the IHG. These must be completed for guarantee to apply. • Schedule 3 follow up appointments 30-days apart.

22. The Health Guide

23. Hidden Foods Hidden foods can cause the patient to fail, because they think they are following the diet and do not even know they are eating bad foods that are hidden in some of the meals they are eating.

24. Food Substitutions When you tell a patient they cannot eat something, it is very helpful if you tell them what they can substitute that food for.

25. Symptom Check Sheets There are four symptom check sheets in the IHG. The first one should be completed just before starting the elimination diet. The other three are completed every 30-days. It is highly recommended that 3 FU appt’s are scheduled (one every 30-days) before the pt leaves the office.

26. Daily Food Record The daily food record should be completed everyday. There are two main reasons to complete this form: 1. It makes the patient pay attention to what he/she is eating. 2. It allows the doctor and or Immuno Labs the ability to find hidden foods the patient might not recognize as being bad for them.

27. Reintroducing the foods • The final step to the 90-day elimination diet is reintroducing the bad foods one at a time. • Start with the +1 foods, have the patient add one +1 food to their normal daily diet and pay attention to how they feel. If after 72 hours they do not feel any different (bad) they can add that food back into their daily diet. • Repeat step 1 for all foods on the list. If a reaction is noticed, that food should be written on a list to stay away from for another 30-days. Drink lots of water for 72 hour before moving on to the next food. • Repeat step 1 & 2. • When all foods have been reintroduced the patient should have a much smaller list of + foods. They can repeat step 1,2 & 3 on these foods after 30-days. Foods remaining on the list are foods the patient should never eat again or they could cause the symptoms to return.

28. HELP There is always help for both the patient and the doctor by calling Immuno Labs. 800-231-9197 Or Us our 24/7 on-line CHAT at www.BetterHealthUSA.com