Patient Flow –Partner PT or Chiropractic Clinic

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1. Initial Patient Contact & Scheduling

The PT or Chiropractic Clinic serves as the first point of contact for the patient.
Patients schedule appointments directly with the clinic for physical therapy, chiropractic care, or integrated wellness services.
If the patient expresses interest in medical services (e.g., peptides, HRT, NAD+, IV therapy, bloodwork, etc.):
- The clinic either schedules the visit directly through the APL scheduling link (embedded in their site or portal), or
- Provides the patient a direct link to schedule via APL’s online booking system.

Ownership & Access:

The clinic owns the initial patient relationship and controls non-medical scheduling and payments.
APL receives only administrative and scheduling data related to medical services — no medical data is shared until consents are signed within the EHR.

2. Intake and Data Entry

During the clinic’s intake process, the patient completes:
- The clinic’s own intake documentation (for PT/chiropractic services).
- The APL medical intake form (secure link via Practice Better).

Data Flow:

The clinic’s forms stay within the clinic’s own documentation system.
The APL intake automatically populates the shared Practice Better EHR, where:
- Administrative and scheduling data are accessible to APL.
- Clinical data and PHI related to medical care are accessible only to Medical Group.

3. Consents and Documentation

APL maintains administrative and medical consents, including:
- Scheduling authorization
- Financial policy
- Communication and data-sharing consent
- Telehealth consent
- Informed treatment consent
- HIPAA authorization
The clinic obtains its own service consents for PT or chiropractic care, separate from APL.

All consents are securely stored within Practice Better, categorized by type and visible only to the appropriate entity.

4. Consultation and Care Coordination

APL contacts the patient to confirm and schedule their telehealth visit with the RN or Dr.Thomas.
During the telehealth visit:
- The medical provider reviews intake data.
- Discusses symptoms, goals, and relevant history.
- Recommends a medical plan (e.g., lab testing, IV therapy, peptides, HRT, NAD+).

Data Flow:

All medical notes and treatment plans are recorded in the Practice Better EHR.
The clinic may receive a general summary (e.g., “medical clearance received” or “supplement protocol recommended”), but not PHI or detailed prescriptions.

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Medical Treatment Execution

If medical treatment is ordered (labs, IV therapy, peptides, etc.):
- APL coordinates and schedules all appointments directly with the patient.
- The RN or Dr. Thomas conducts or oversees medical services.
- All documentation (orders, lab results, treatment notes) resides in Practice Better under patient medical records.
APL manages all logistical and compliance elements:
- Medical refrigerator/freezer maintenance
- Lab transport and specimen tracking
- Temperature and cleaning logs
There is no direct payment to APL from the patient.

Clinic Role:

The clinic may provide treatment space for medical services under a separate facilities use agreement.
The clinic does not store medical products, handle specimens, or document medical interventions.

Communication and Follow-Up

All medical communication occurs through Practice Better (HIPAA-compliant).
The clinic may coordinate general scheduling and patient support but does not access medical records or messages.
Follow-up telehealth visits, prescription renewals, and lab result reviews are handled by and scheduled by APL.

Reporting and Monthly Reconciliation

APL compiles a monthly reconciliation of all medical services delivered through partner clinics.
Reports include:
- Total patients served
- Services rendered
- Associated revenues and cost allocations
APL provides transparency to each partner clinic regarding the administrative breakdown but excludes any PHI or medical detail.

Data Ownership and Compliance

The Practice Better EHR serves as the shared system of record for all medical data.
- APL owns and retains all medical data, administrative and operational data.
- Clinics retain non-medical documentation in their own systems.
Role-based access controls ensure each entity only accesses the minimum data necessary for their role.
Business Associate Agreements (BAAs) exist between APL, and each partner clinic to ensure HIPAA compliance and define data handling boundaries.

09. Summary of Responsibilities

Entity

Role

Responsibilities

PT/Chiropractic Clinic

APL (Apex Performance & Longevity)

TCUBED, LLC

Non-medical provider

Administrator / MSO

Medical provider

Collects patient payments, manages scheduling, maintains patient relationship, and pays APL per invoice

Coordinates medical scheduling, maintains administrative data and consents, invoices clinics, and pays TCUBED for medical services

Conducts telehealth visits, orders labs and prescriptions, performs or oversees medical treatments, retains all medical data and consents

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10. Compliance Summary

One EHR (Practice Better): Used jointly with role-based permissions.
No Dual Billing: Patients pay the clinic only once.
No Fee-Splitting: Clinic pays APL, not Medical Group directly.
Full Transparency: APL reconciles and remits payments monthly with documented breakdowns.
Audit & Oversight: Regular reviews by Kate Bolia (Privacy/Security Officer) and Dr. Tommy Thomas (Medical Director).

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11. Example Consent for Intravenous and SubQ Injection Therapy

Informed Consent for Intravenous (IV) and Injectable Therapy

This document is intended to serve as confirmation of informed consent for IV and Injectable Therapy as ordered by Apex Performance and Longevity. I have informed the provider of any known allergies to drugs, supplements, or other substances that may be included in the ingredients of my solutions, or of any past reactions to anesthetics. In doing so, I understand that the sole risk of injury or harm that results from any participation in said therapy rests solely with me insofar as to the extent to which I do not disclose those allergies in advance.

I have informed the provider of all current medications and supplements. In doing so, I understand that the sole risk of injury or harm that results from any participation in said therapy rests solely with me in so far as to the extent to which I do not disclose my health conditions, medications, or supplements in advance.

I have informed the provider of all medical conditions, diseases, and illnesses. I attest that I have never been diagnosed with or treated for any such conditions that would put me at increased risk while receiving IV and/ or injectable therapy services by Apex Performance and Longevity. I understand that I will be screened for said conditions prior to initiation of services. I understand that I have the right to be informed of the risks and benefits before therapy administration. No procedures will be performed until I have had an opportunity to receive such information and to give my informed consent. Apex Performance and Longevity therapies are not intended for emergency care. The intravenous (IV) procedure involves inserting a needle into your vein and infusing the prescribed nutrients and/or medications over a determined period of time. That time will vary depending on your anatomy and infusion rate.

I understand that IV therapy carries with it both risks and benefits. Some of those risks and potential side effects include, but are not limited to

Discomfort, soreness, bleeding, bruising, pain and possible scarring at the site of injection.
Inflammation of the vein used for injection, phlebitis, metabolic disturbances, and injury.
Lightheadedness or fainting
Severe reaction to medication, supplement or vitamin therapy; anaphylaxis, cardiac arrest or death.
Volume overload
Air embolism.
Fluid Infiltration

I am aware that other unforeseeable complications could occur. I understand the risks and benefits of the procedure and have had the opportunity to have all of my questions answered. I understand that I have the right to consent to or refuse any proposed treatment at any time before or during its performance. My signature on this form affirms that I have given my consent to IV therapy with any different or further procedure/medications, which in the opinion of my physician(s) or other(s) associated with this practice, may be indicated.

Lastly, I attest that I am not under the influence of illegal drugs or substances at the time of therapy. I agree that I am not using said therapy to recover from any drug related symptoms. I understand that if any suspicion of such is made by the provider, my right to therapy administration will be waived and will not be subject to a refund.

I understand that a record of my treatment will be generated with each visit. We are committed to your privacy and all health care information provided to Apex Performance and Longevity will be protected. Any disclosures of PHI (protected health information) will therefore require authorization.

I understand the information provided on this form and agree to all therein. I understand that there is no implied or stated guarantee of success or effectiveness of any treatment. The procedures set forth above have been adequately explained to me by my provider. I understand that I am free to withdraw my consent and discontinue participation in their treatments at any time. My signature below confirms that I am not:

Pregnant
Been given a diagnosis of Congestive Heart Failure (CHD)
Been given a diagnosis of Kidney Disease

I understand that, except in emergencies, I must give 24 hours notice of intent to cancel or reschedule my appointment. I understand that I may incur the full fee for treatment, regardless of amount of supply used due to wasted materials.

Client Name

Client Signature

Date